Editorial Comment

Abstract

Semen analyses remain the foundation of andrological work-up in the evaluation of male fertility and infertility. It is highly quantitative based on visual parameters and does not usually take into consideration the functionality of the sperm itself as measured by certain other parameters such as reactive oxygen species (ROS) and/or DNA fragmentation. 1 Lamb D. Semen analysis in 21st century medicine: the need for sperm function testing. Asian J Androl. 2010; 12: 64-70 Crossref PubMed Scopus (48) Google Scholar These have been shown to potentially affect pregnancy outcomes along with quantitative parameters. Semen parameters rely on the physiological and pathophysiological mechanisms of spermato genesis in the seminiferous tubules; the cycle of production; issues of processing and transportation through the reproductive tract; storage in the reproductive tract; and the natural degradation process of the sperm if not ejaculated. All these factors influence clinical management. As such, one of the simplest ways to consider this process and the quality of semen parameters is the abstinence period since last ejaculation, but the exact time frame is not completely defined in the literature. 2 Amann R.P. Considerations in evaluating human spermatogenesis on the basis of total sperm per ejaculate. J Androl. 2009; 30: 626-641 Crossref PubMed Scopus (34) Google Scholar How frequent is too frequent for ejaculation to deplete the sperm stored or produced or time to “restock” between ejaculations? How long is too long before sperm is broken down or become ‘stagnant”? 3 Mortimer D. Templeton A.A. Lenton E.A. Coleman R.A. Influence of abstinence and ejaculation-to-analysis delay on semen analysis parameters of suspected infertile men. Arch Androl. 1982; 8: 251-256 Crossref PubMed Scopus (45) Google Scholar , 4 Correa-Pérez J.R. Fernández-Pelegrina R. Aslanis P. Zavos P.M. Clinical management of men producing ejaculates characterized by high levels of dead sperm and altered seminal plasma factors consistent with epididymal necrospermia. Fertil Steril. 2004; 8: 1148-1150 Abstract Full Text Full Text PDF Scopus (20) Google Scholar The World Health Organization (WHO) Laboratory Manual for the Examination and Processing of Human Semen (5th Edition) 2010, which is viewed as the authoritative text on the matter, states, “The sample should be collected after a minimum of 2 days and a maximum of 7 days of sexual abstinence. If additional samples are required, the number of days of sexual abstinence should be as constant as possible at each visit.” 5 Cooper T.G. Keck C. Oberdieck U. Nieschlag E. Effects of multiple ejaculations after extended periods of sexual abstinence on total, motile and normal sperm numbers, as well as accessory gland secretions, from healthy normal and oligozoospermic men. Hum Reprod. 1993; 8: 1251-1258 PubMed Google Scholar , 6 Tyler J.P. Crockett N.G. Driscoll G.L. Studies of human seminal parameters with frequent ejaculation. I. Clinical characteristics. Clin Reprod Fertil. 1982; 1: 273-285 Google Scholar , 7 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: 57-65 Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar Amann and Chapman performed an eloquent study in 2009 that showed that to obtain meaningful values for diagnosis and distinguishing men with high or low sperm production and that the best abstinence period was more in the 42-54 hour time frame to an upper limit of 64 hours. 8 Amann R.P. Chapman P.L. Total sperm per ejaculate of men: obtaining a meaningful value or a mean value with appropriate precision. J Androl. 2009; 30: 642-649 Crossref PubMed Scopus (20) Google Scholar For men producing few sperm, up to 7 days was recommended. 8 Amann R.P. Chapman P.L. Total sperm per ejaculate of men: obtaining a meaningful value or a mean value with appropriate precision. J Androl. 2009; 30: 642-649 Crossref PubMed Scopus (20) Google Scholar