OPTIMAL TIMING FOR REPEAT SEMEN ANALYSIS DURING MALE INFERTILITY EVALUATION

Abstract

To assess if the 4-week time period between semen analysis during the work-up of male infertility is optimal, or if an alternative time period may be more desirable. Retrospective study of prospectively collected data. Semen analyses were reviewed between 1997 and 2018 at Weill Cornell in New York City. Included men had two semen analyses completed at our institution, whom had no previous fertility interventions, and had semen analyses completed within 90 days of each other. Men with azoospermia or incomplete data were excluded. We examined Pearson correlation coefficients (r) between sperm concentration (million/ml) total sperm count (million), pH, volume (mL), motility (%) and progressive motility (grade 1-4), and morphology (%) for each pair of semen samples and assessed these over weekly time periods. A total of 1080 semen samples were included for assessment from a total of 540 men. Optimal correlation for volume occurred at weeks 2 (r=0.807), 8 (r=0.802), and 12 (r=0.797). For concentration correlation was maximized at weeks 1 (r=0.950), 4 (r=0.840), and 5 (r=0.798). Total sperm count correlated at weeks 1 (r=0.929), and 2 (r=0.729), and 4 (r=0.806). Motility was maximally correlated at week 1 (r=0.711), 10 (r=0.760) and 13 (r=0.708). Morphology was optimally correlated at week 1 (0.935), 2 (r=0.818) and 10 (r=0.839). Historically, repeat semen analysis has been suggested at least four weeks after the initial sample. Our data suggests that this may not be the optimal time. More optimal time periods are within the first two weeks or beyond two months depending on the parameter. These data suggests that the optimal time period for repeat semen analysis should be individualized depending on results of the initial analysis and factors such as recent changes in medications, lifestyle issues such as drug and alcohol abuse, weight change, stress, etc. Further, large studies are required for investigation of this trend.