Effect of Ejaculatory Abstinence Period on Sperm DNA Fragmentation and Pregnancy Outcome of Intrauterine Insemination Cycles: A Prospective Randomized Study

Overview

Journal Arch Gynecol Obstet

Specialty Gynecology & Obstetrics

Date 2020 Sep 9

PMID 32902676

Citations 8

Authors

Cihan Kabukcu

Nazli Cil

Umit Cabus

Erkan Alatas

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the effect of the ejaculatory abstinence period on sperm DNA fragmentation and pregnancy rates in IUI cycles.

Methods: One hundred and twenty couples with unexplained infertility were prospectively randomized into two groups on the second day of their cycle. In group A, patients had 1-day ejaculatory abstinence period; in group B patients had 3-day ejaculatory abstinence period. Each patient was stimulated with gonadotropins, and IUI was performed. The primary outcome measure was clinical pregnancy and sperm DNA fragmentation rate.

Results: The pregnancy rate was 17.3% and 18.5% in group A and group B, respectively. No significant difference was found among the groups (p = 0.803). The sperm DNA fragmentation rate for group A (20.71 ± 11.01) and group B (23.78 ± 12.64) were almost similar (p = 0.187). The sperm DNA fragmentation rate was 24.89 ± 12.89 in pregnant couples and 21.71 ± 11.69 in non-pregnant couples (p = 0.288).

Conclusion: Even after a short abstinence period of 1 day, compared to the standard abstinence period of 3 days, pregnancy rates are similar among unexplained infertility couples undergoing ovarian stimulation and IUI.

Clinicaltrials: The study was registered at ClinicalTrials.gov with ID NCT04361292. Date of registration: 27 April 2020. The study was registered retrospectively.

Citing Articles

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References

Ombelet W, Dhont N, Thijssen A, Bosmans E, Kruger T . Semen quality and prediction of IUI success in male subfertility: a systematic review. Reprod Biomed Online. 2014; 28(3):300-9. DOI: 10.1016/j.rbmo.2013.10.023. View

Ayeleke R, Asseler J, Cohlen B, Veltman-Verhulst S . Intra-uterine insemination for unexplained subfertility. Cochrane Database Syst Rev. 2020; 3:CD001838. PMC: 7059962. DOI: 10.1002/14651858.CD001838.pub6. View

Farquhar C, Liu E, Armstrong S, Arroll N, Lensen S, Brown J . Intrauterine insemination with ovarian stimulation versus expectant management for unexplained infertility (TUI): a pragmatic, open-label, randomised, controlled, two-centre trial. Lancet. 2017; 391(10119):441-450. DOI: 10.1016/S0140-6736(17)32406-6. View

Nuojua-Huttunen S, Tomas C, Bloigu R, Tuomivaara L, Martikainen H . Intrauterine insemination treatment in subfertility: an analysis of factors affecting outcome. Hum Reprod. 1999; 14(3):698-703. DOI: 10.1093/humrep/14.3.698. View

Houmard B, Juang M, Soules M, Fujimoto V . Factors influencing pregnancy rates with a combined clomiphene citrate/gonadotropin protocol for non-assisted reproductive technology fertility treatment. Fertil Steril. 2002; 77(2):384-6. DOI: 10.1016/s0015-0282(01)02990-9. View

Iberico G, Vioque J, Ariza N, Lozano J, Roca M, Llacer J . Analysis of factors influencing pregnancy rates in homologous intrauterine insemination. Fertil Steril. 2004; 81(5):1308-13. DOI: 10.1016/j.fertnstert.2003.09.062. View

Erdem A, Erdem M, Atmaca S, Korucuoglu U, Karabacak O . Factors affecting live birth rate in intrauterine insemination cycles with recombinant gonadotrophin stimulation. Reprod Biomed Online. 2008; 17(2):199-206. DOI: 10.1016/s1472-6483(10)60195-2. View

Duran E, Morshedi M, Taylor S, Oehninger S . Sperm DNA quality predicts intrauterine insemination outcome: a prospective cohort study. Hum Reprod. 2002; 17(12):3122-8. DOI: 10.1093/humrep/17.12.3122. View

Bungum M, Humaidan P, Spano M, Jepson K, Bungum L, Giwercman A . The predictive value of sperm chromatin structure assay (SCSA) parameters for the outcome of intrauterine insemination, IVF and ICSI. Hum Reprod. 2004; 19(6):1401-8. DOI: 10.1093/humrep/deh280. View

10.

Bungum M, Humaidan P, Axmon A, Spano M, Bungum L, Erenpreiss J . Sperm DNA integrity assessment in prediction of assisted reproduction technology outcome. Hum Reprod. 2006; 22(1):174-9. DOI: 10.1093/humrep/del326. View

11.

Muriel L, Meseguer M, Fernandez J, Alvarez J, Remohi J, Pellicer A . Value of the sperm chromatin dispersion test in predicting pregnancy outcome in intrauterine insemination: a blind prospective study. Hum Reprod. 2005; 21(3):738-44. DOI: 10.1093/humrep/dei403. View

12.

Thomson L, Zieschang J, Clark A . Oxidative deoxyribonucleic acid damage in sperm has a negative impact on clinical pregnancy rate in intrauterine insemination but not intracytoplasmic sperm injection cycles. Fertil Steril. 2011; 96(4):843-7. DOI: 10.1016/j.fertnstert.2011.07.356. View

13.

Yang H, Li G, Jin H, Guo Y, Sun Y . The effect of sperm DNA fragmentation index on assisted reproductive technology outcomes and its relationship with semen parameters and lifestyle. Transl Androl Urol. 2019; 8(4):356-365. PMC: 6732090. DOI: 10.21037/tau.2019.06.22. View

14.

Hanson B, Aston K, Jenkins T, Carrell D, Hotaling J . The impact of ejaculatory abstinence on semen analysis parameters: a systematic review. J Assist Reprod Genet. 2017; 35(2):213-220. PMC: 5845044. DOI: 10.1007/s10815-017-1086-0. View

15.

Agarwal A, Gupta S, Du Plessis S, Sharma R, Esteves S, Cirenza C . Abstinence Time and Its Impact on Basic and Advanced Semen Parameters. Urology. 2016; 94:102-10. DOI: 10.1016/j.urology.2016.03.059. View

16.

Sanchez-Martin P, Sanchez-Martin F, Gonzalez-Martinez M, Gosalvez J . Increased pregnancy after reduced male abstinence. Syst Biol Reprod Med. 2013; 59(5):256-60. DOI: 10.3109/19396368.2013.790919. View

17.

Pons I, Cercas R, Villas C, Brana C, Fernandez-Shaw S . One abstinence day decreases sperm DNA fragmentation in 90 % of selected patients. J Assist Reprod Genet. 2013; 30(9):1211-8. PMC: 3800522. DOI: 10.1007/s10815-013-0089-8. View

18.

De Jonge C, Lafromboise M, Bosmans E, Ombelet W, Cox A, Nijs M . Influence of the abstinence period on human sperm quality. Fertil Steril. 2004; 82(1):57-65. DOI: 10.1016/j.fertnstert.2004.03.014. View

19.

Welliver C, Benson A, Frederick L, Leader B, Tirado E, Feustel P . Analysis of semen parameters during 2 weeks of daily ejaculation: a first in humans study. Transl Androl Urol. 2016; 5(5):749-755. PMC: 5071206. DOI: 10.21037/tau.2016.08.20. View

20.

Mayorga-Torres J, Agarwal A, Roychoudhury S, Cadavid A, Cardona-Maya W . Can a Short Term of Repeated Ejaculations Affect Seminal Parameters?. J Reprod Infertil. 2016; 17(3):177-83. PMC: 4947206. View