Abstinence Time Research Articles

Association Between Zinc Ion Concentrations in Seminal Plasma and Sperm Quality: A Chinese Cross-Sectional Study.

This study investigates the impacts of zinc ion concentration in in seminal plasma and the total amount of Zn2+ per ejaculation on sperm quality evaluation parameters. In addition, we assessed the reliability of using zinc content in seminal plasma to evaluate sperm quality. We analyzed semen from 964 men and found that men over 40years old had significantly lower concentrations of Zn2+ in ejaculated semen compared to other age groups (p < 0.05), with no significant difference in Zn2+ concentrations among other age groups (p > 0.05). The total amount of Zn2+ in one ejaculation did not show a statistical difference between the normal semen and the abnormal semen groups (p > 0.05). Statistical differences were observed in sperm kinetic parameters and DNA fragmentation index between the normal Zn2+ total amount group and the abnormal group (p < 0.05). However, there was no statistical difference in morphological parameters (p > 0.05). Spearman correlation analysis showed a negative correlation between Zn2+ concentrations in seminal plasma, age, and sperm fructose and a positive correlation between semen volume, abstinence time, sperm concentration, neutral α-glycosidase, and citric acid content (p < 0.05). The receiver operating characteristic curve analysis demonstrated that Zn2+ concentrations had poor accuracy and specificity in assessing sperm quality (p > 0.05). Although there is a partial correlation between Zn2+ concentrations in seminal plasma and certain semen quality parameters, relying solely on Zn2+ concentrations to evaluate sperm quality lacks accuracy and specificity.

Short-term alcohol abstinence prior to liver transplantation and impact on rejection

Background & AimsAlcohol-associated liver disease (ALD) is a leading indication for liver transplant (LT). Historically, centers implemented 6-month abstinence periods prior to LT listing; however, the impact of this abstinence time on post-transplant rejection outcomes is unclear. This study evaluated if short-term abstinence is associated with increased rejection post-LT. MethodsThis single-center, retrospective, cohort included adult LT recipients from 11/1/2015 to 7/21/2021 with a primary indication of ALD. Patients were grouped by pre-transplant abstinence time of <6 or ≥6-months. The primary endpoint was biopsy proven acute rejection (BPAR) at 12-months post-LT. Secondary endpoints were infection, alcohol relapse, patient and graft survival at 12-months. ResultsOverall, 228 LT recipients met inclusion criteria (<6-months: n = 130; ≥6-months: n = 98). Patients with <6-months of abstinence were younger, had higher MELD scores, and more renal replacement therapy needs. Incidence of BPAR within 12 months of LT was 28 % in the <6-month group vs. 18 % in the ≥6-month group (p = 0.078). Tacrolimus initiation was lower at 7 days post-LT in the <6-month group (77% vs. 89 %; p = 0.029). Delay in tacrolimus initiation past 7 days post-LT was associated with greater BPAR (35% vs. 12 %; p = 0.0001). Increased bloodstream infections (21% vs. 7 %; p = 0.04) and CMV DNAemia (31% vs. 7 %; p = 0.0008) were seen in the <6-month group. Patient and graft survival was similar between groups. ConclusionsAbstinence time of <6-months was not associated with more BPAR within 12-months post-LT. The <6-month group was sicker at time of LT, which correlates to lower tacrolimus exposure early post-LT and heightened incidence of bacteremia and CMV viremia. Given the high acuity of the <6-month abstinence group, the risk of BPAR must be closely balanced with infection risk.

Nursing interventions in patients with substance use disorders. A systematic review

ObjectiveTo analyze the current available evidence on non-pharmacological interventions for increasing the withdrawal of patients with substance use disorder. MethodA systematic review of randomized clinical trials with a control group has been carried out where a non-pharmacological intervention is carried out in which nurses participate. The search was carried out in Pubmed, Cinahl, Web of Science, Scopus and Cochrane. randomized clinical trials with a control group published between 2018 and 2023 were selected. Results15 articles were selected. A longer abstinence time was observed in the interventions that proposed a personalized telematic follow-up with a health worker, the establishment of the figure of the care coordinator or financial rewards based on the abstinence time. No significant differences regarding abstinence were observed in the formative interventions or with relaxation techniques only. However, relaxation techniques combined with other interventions could be effective. ConclusionsThe identified interventions can be incorporated into nursing practice. They present encouraging results, although it would be advisable to study their long-term effectiveness.

P-083 Short ejaculatory abstinence time of 2 hours results in higher pregnancy outcomes compared to the recommended abstinence period of 2-7 days

Abstract Study question What is the impact of a short abstinence (2h) compared to the recommended (2-7 days) ejaculatory abstinence time on embryo utilization rate and pregnancy outcome? Summary answer A short abstinence of 2 hours results in similar embryo utilization rates, but in reduced sperm DNA fragmentation and higher pregnancy rates. What is known already Semen parameters exhibit variability among and within individuals, and ejaculatory abstinence time (EA) is a known factor contributing to intra-individual variation. Despite the challenge of providing a specific recommendation for the optimal timeframe, recent studies suggested that a shorter abstinence is likely to decrease DNA fragmentation levels in semen and improve pregnancy and live birth rates following assisted reproductive technology. At present, ESHRE recommends a more limited range than the WHO manual, advising an ejaculatory abstinence of 3 to 4 days. Study design, size, duration This prospective proof-of-concept sibling oocyte study (n = 100 cycles), conducted between January 2018 and June 2023, required two sperm samples per patient. The initial sperm sample was produced on the day of oocyte retrieval following the requested abstinence period of 2-7 days. The second sperm sample was collected 2 hours later. Sibling oocytes were randomly allocated to injection with the first or second sample. Sibling oocytes of each patient were cultured under the same conditions. Participants/materials, setting, methods Inclusion criteria were ≥ 6 mature oocytes (MII), fresh ejaculates with concentration &amp;gt;1x106/ml, ICSI with subsequent blastocyst culture. Endpoints were pregnancy outcome, fertilization, blastocyst development, utilization rate, sperm concentration/motility and DNA fragmentation index (DFI) measured by TUNEL. Statistical analysis was done taking into account female age and clustering. A total of 104 couples consented to provide two samples on the day of oocyte retrieval and were enrolled. Main results and the role of chance Average abstinence periods of 98:48h±20:01 vs 02:05h±00:18 were observed. Sperm concentration (x106/ml), progressive forward motility and DFI, were 46.53±39.6 vs 37.0±37.1 (p &amp;lt; 0.001), 52.14%±20.1 vs 49.79%±20.4 (p = 0.152) and 6.76%±7.0 vs 5.37%±7.2 (p = 0.024), respectively. Of the 1282 collected oocytes, 634 were injected with the first sperm sample and 648 with the ‘2h EA sample’. Fertilization rates per MII (79.3% vs 80.7%, p = 0.154) and good-quality day 3 embryos (76.7% vs 77.6%, p = 0.276) were similar between both groups. From the 93 patients with blastocyst culture (with average female age of 33.9±5.0 years; average male age of 36.4±6.6 years), 1173 oocytes were stratified for injection: 580 (first sample) and 593 (second sample), respectively. Fertilization rates (81.4% vs 82.3%, p = 0.074) and good-quality day 5 blastocysts (46.2% vs 49.5%, p = 0.534) did not differ between the groups. Utilization rate per inseminated (30.5% vs 35.8%, p = 0.126) or fertilized (37.5% vs 43.4%, p = 0.153) oocyte was similar between the groups. Single fresh and frozen embryo transfers were compared between embryos generated after the requested (2-7 days; n = 91) and short (2h; n = 94) abstinence. Pregnancy rate was significantly higher after short abstinence: 49.5% (45/91) vs 62.8% (59/94); p = 0.01. Ongoing pregnancy rate was 31.9% (29/91) and 40.4% (38/94); p = 0.10. Limitations, reasons for caution This is a prospective proof-of-concept study, not powered to detect differences in utilization and pregnancy outcomes. Not all patient are capable of producing two sperm samples within 2 hours from each other. Wider implications of the findings The results indicate a significant, yet not relevant difference in DNA fragmentation index (DFI) but a relevant difference in pregnancy rate between the two groups. If increased live birth rates are obtained after short abstinence, recommendations concerning EA might need adaptation. Trial registration number NCT03323892

Association of lifestyle and occupational exposure factors with human semen quality: a cross-sectional study of 1060 participants

The incidence of male infertility (MI) is rising annually. However, the lifestyle and occupational exposure factors contributing to MI remain incompletely understood. This study explored the effects of self-reported lifestyle and occupational exposure factors on semen quality. Among 1060 subjects invited to participate, 826 were eligible. The participants’ general characteristics, lifestyle, and occupational exposure factors were collected immediately before or after semen evaluation through an online questionnaire. Initially, univariate analysis was used to investigate the relationship between the abovementioned factors and semen quality. The results indicated significant associations between low semen quality and various factors, including age, BMI, infertility type and duration, abstinence time, semen and sperm parameters, smoking, alcohol consumption, irregular sleep habits, and frequent exposure to high temperatures and chemicals at work (p < 0.05). Then, multivariate analysis was conducted to identify factors independently associated with low semen quality. Adjustment for relevant confounders was achieved by including factors with a p-value < 0.25 from univariate analyses as covariates in the binomial and ordered logistic regression models. The results suggested that alcohol consumption was a positive factor for sperm concentration (odds ratio [OR] = 0.60; 95% confidence interval [CI] = 0.36–0.99; p = 0.045). The groups with a BMI ≥ 24 and <28 kg/m2 showed a significant decrease in sperm progressive motility when compared to the reference group (BMI < 24 kg/m2) (OR = 0.63; 95% CI = 0.46–0.87, p = 0.005). In addition, the groups that drank green tea <1 time/week (OR = 1.52, 95% CI = 1.05–2.2) and 1–4 times/week (OR = 1.61, 95% CI = 1.02–2.54) exhibited significantly increased sperm DFI values compared with the group that drank green tea 5–7 times/week. In conclusion, these findings underscore the importance of maintaining a normal weight and regularly consuming green tea for men.

Utility of scores to predict alcohol use after liver transplant: Take them with a grain of salt.

The Sustained Alcohol use post-Liver Transplant (SALT) and the High-Risk Alcohol Relapse (HRAR) scores were developed to predict a return to alcohol use after a liver transplant (LT) for alcohol-associated liver disease. A retrospective analysis of deceased donor LT from October 2018 to April 2022 was performed. All patients underwent careful pre-LT psychosocial evaluation. Data on alcohol use, substance abuse, prior rehabilitation, and legal issues were collected. After LT, all were encouraged to participate in rehabilitation programs and underwent interval phosphatidylethanol testing. Patients with alcohol-associated liver disease were stratified by < or > 6 months of sobriety before listing. Those with <6 months were further stratified as acute alcoholic hepatitis (AH) by NIAAA criteria and non-AH. The primary outcome was the utility of the SALT (<5 vs. ≥5) and HRAR (<3 vs. ≥3) scores to predict a return to alcohol use (+phosphatidylethanol) within 1 year after LT. Of the 365 LT, 86 had > 6 months of sobriety, and 85 had <6 months of sobriety; 41 with AH and 44 non-AH. In those with AH, the mean time of abstinence to LT was 58 days, and 71% failed prior rehabilitation. Following LT, the return to drinking was similar in the AH (24%) compared to <6-month non-AH (15%) and >6-month alcohol-associated liver disease (22%). Only 4% had returned to heavy drinking. The accuracy of both the SALT and HRAR scores to predict a return to alcohol was low (accuracy 61%-63%) with poor sensitivity (46% and 37%), specificity (67%-68%), positive predictive value (22%-26%) with moderate negative predictive value (81%-83%), respectively with higher negative predictive values (95%) in predicting a return to heavy drinking. Both SALT and HRAR scores had good negative predictive value in identifying patients at low risk for recidivism.

Effects of long and short ejaculatory abstinence on sperm parameters: a meta-analysis of randomized-controlled trials.

This study aimed to investigate the effects of ejaculatory abstinence on sperm parameters. This analysis was registered in PROSPERO (CRD42023472124). We performed a search on PubMed using the following text terms: (("sperm parameters" OR "sperm analysis" [Mesh]) AND ("sperm DNA fragmentation" OR "DNA fragmentation" [Mesh]) AND ("sexual abstinence" [Mesh] OR "abstinence")) and an advanced search in Scopus using the terms ("sperm parameters" OR "sperm parameters" OR "DNA fragmentation") AND ("abstinence"). The sperm parameters that were investigated were sperm volume, total sperm motility, progressive sperm motility, sperm concentration, sperm morphology, and sperm DNA fragmentation (SDF). A two-day cut-off as a "short" or "long" abstinence period has been defined. Thirteen studies published between 2013 and 2022 were included in this meta-analysis. A total of 2,315 patients, ranging from 6 to 836 from each cohort, were enrolled in the study. We showed that longer abstinence time was associated with greater sperm concentration (mean difference [MD]: 8.19; p <0.01), sperm volume (MD: 0.96; p <0.01), and higher SDF (MD: 3.46; p <0.01), but lower progressive sperm motility (MD: -1.83; p <0.01). Otherwise, no statistically significant difference was observed in patients with longer vs. shorter abstinence times regarding total sperm motility (MD: -1.83; p = 0.06). Meta-regression analysis showed that days of abstinence were positively and linearly related to sperm concentration (slope: 3.74; p <0.01) and SDF (slope: 0.65; p = 0.044). According to our data, short ejaculatory abstinence is associated with better sperm quality. Indeed, a higher percentage of progressive sperm motility and lower levels of SDF have been reported in a short abstinence cohort. In contrast, the long abstinence group reported a higher sperm concentration. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023472124.

Relationship between male aging and semen quality: a retrospective study on over 2500 men

PurposeWe aimed to evaluate whether and to what extent an association exists between male aging and worsening of semen parameters and to determine whether a threshold age can be identified above which the decline in semen quality becomes statistically significant.Methods2612 men (age: 16–56 years) attending an andrology outpatient clinic for semen analysis and clinical evaluation were studied. Semen analyses were performed according to the ongoing WHO-recommended procedures. Total motile count (TMC) and total progressive motile count (TPMC) were calculated by multiplying total sperm number by total motility and progressive motility, respectively.ResultsSignificant negative correlations were found between age and total motility (r = − 0.131, p < 0.0001), progressive motility (r = − 0.112, p < 0.0001), TPMC (r = − 0.042, p = 0.037), and normal sperm morphology (r = − 0.053, p = 0.007). All these associations persisted in multivariate regression models adjusted for abstinence time, smoking, history of male accessory gland infections, varicocele and the year in which semen analysis was performed. When comparisons were performed among quartiles of increasing age, the fourth quartile, corresponding to the age group > 40 years, was associated with a significant decrease in total and progressive motility. An earlier decline in the TPMC and percentage of normal forms was also observed.ConclusionAdvancing male age exhibits an independent association with a decrease in the percentage of motile and morphologically normal spermatozoa, with greater evidence from the age of > 40 years. Further studies are warranted to elucidate the mechanisms and clinical reflections of these associations.

(378) Shorter Abstinence is Associated with a Decrease in Semen Round Cells but Not in Semen Leukocytes

Abstract Introduction The connection between abstinence times and semen round cells and pyospermia is not well understood. However, frequent ejaculation is a commonly prescribed treatment for pyospermia. Objective We sought to identify if a correlation exists between abstinence periods and round cells and semen leukocytes. Methods We conducted a retrospective review of men presenting to a high-volume fertility center for evaluation who had semen samples assessed for leukocytes between 2/1/2022 and 1/1/2023. Azoospermic men and men with abstinence times over 14 days were excluded. We recorded round cells, the presence of leukocytes, and days of abstinence prior to the sample. The presence of leukocytes was detected using test strips which report a positive result if the concentration of leukocytes was greater or equal to 1 million/ml. The study received IRB approval. Pearson correlations (assumes linear relationship) were used as well as generalized additive models (GAMs), which allow for a non-linear relationship between abstinence and the outcome. For analysis of semen leukocytes, a positive result was coded as 1 and a negative result was coded as 0. Round cells were log-transformed prior to calculating correlation. The estimated relationships from GAMs were plotted graphically and summarized via average marginal slopes. Results A total of 382 semen analyses were included, with a mean abstinence period of 3.67 days (SD: 2.11). The number of round cells ranged from 0.2 to 44.0 million (mean: 4.21 million, SD: 4.68), with 19.1% (n = 73) of samples testing positive for leukocytes. Days of abstinence and round cells are significantly correlated according to a Pearson correlation (r = 0.14, p = 0.006). According to the GAM, with each day increase in abstinence, a 0.52 million increase in round cells is expected (CI 0.25-0.79 million; p&amp;lt;0.05). There is an increase in round cells from 0 to 5 days of abstinence before plateauing. Beyond 10 days there is a large degree of uncertainty, due to a low number of observations. When patients with negative pyospermia tests were excluded, there is no linear correlation (r = 0.11, p = 0.36), however, the GAM appears similar to the original sample (1.2; 0.2, 2.1; p&amp;lt;0.05). Semen leukocytes and abstinence are not significantly correlated according to the Pearson correlation (r = -0.04, p = 0.38). There is little change in the probability of leukocytes being present with respect to abstinence in the GAM (-0.001; CI 2.3-2.1; p = 0.926). There is a similar increase in the degree of uncertainty over 10 days. Conclusions These results demonstrate a statistically significant, yet very minimal linear correlation between round cells and days of abstinence. There is an increasing number of round cells up to 5 days of abstinence before plateauing. However, there was no significant correlation between abstinence time and the presence of leukocytes in the semen in either model. Shorter abstinence times may have a role in reducing semen round cells, but it is unlikely to reduce pyospermia. Providers should be hesitant when suggesting an increased frequency of ejaculation to treat pyospermia. Disclosure No.

New Approach to Early Maladaptive Schemas and its Relationship with Alcohol use Disorder. Role of Psychopathology and Prognostic Variables.

Early maladaptive schemas (EMS), dysfunctional patterns of thought and emotions originated during childhood, latent in most mental disorders, might play a role in the onset of alcohol use disorder (AUD), although their impact on prognosis remains unknown. Our aim is to determine the presence of EMS in patients with AUD and their role in the psychopathology and course of addiction (relapse and withdrawal time). The sample included 104 patients and 100 controls. The diagnosis of AUD was made according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, EMS were determined with the Young Schema Questionnaire in its Spanish version (YSQ-S3) and psychopathology with Symptom Checklist-27 (SCL-27). AUD group showed significantly higher scores in emotional deprivation, confused attachment, emotional inhibition and failure schemas. In addition, vulnerability schema correlated (> 0.500) with all subscales of SCL-27. Whereas social isolation, insufficient self-control and grandiosity schemas correlated with a higher number of relapses. But it was the grandiosity and punishment schemas that correlated with shorter abstinence time. These findings suggest that EMS are overrepresented in the AUD population and some correlate with psychopathology and worse AUD outcomes.

Exploring the Demographic Factors and Facilitators to Addiction Abstinence

Background: Accumulating evidence indicates a remarkable increase in substance addiction. Substance abuse and addiction impose severe social, political, economic, cultural and health-related damages on societies. Little is known, however, about demographic factors and facilitators to addiction abstinence. The purpose of the current study was to explore the factors associated with opioid avoidance.Materials and Methods: This cross-sectional study was performed to record socio-de­mographic data and facilitating factors to abstinence in 600 interviews, according to data collecting forms, with patients who had drug abuse disorders at Shiraz city during 2016. Correlation test, T-test, and ANOVA were employed for data analysis. P&lt;0.05 was considered as the significance level. Result: There was a significant difference between mean abstinence time and demographic factors such as age, sex, occupation and marital status. Also, 53% of people reported that they had the longest abstinence time using the narcotics anonymous (NA) method. TO 33% of patients, the most important facilitating factor in abstinence according to the patient's opinion was family support.Conclusion: Individual, social, psychosocial and medical variables affect the abstinence duration of substance abuse. Identifying the factors associated with longer abstinence can be helpful in designing prevention and treatment programs for variables that affect the recurrence.[GMJ.2018;7:e1074]

Paternal pre-conceptional smoking and semen quality in the adult son.

Growing evidence suggests intergenerational effects of paternal pre-conceptional smoking through the germ line, but its specific impact on offspring semen quality remains uncertain because of challenges in isolating paternal exposure from maternal passive smoking or underreporting. We reran previous analyses estimating differences in semen parameters and testicular size according to paternal smoking in 867 young adult men, adding first-trimester maternal plasma cotinine to the original adjustment for maternal self-reported smoking. We also estimated differences in sperm DNA fragmentation. Paternal smoking was reported by the pregnant women around gestational week 16. Analyses were additionally adjusted for household occupational status, parental ages at birth, maternal pre-pregnancy body mass index and alcohol consumption, and abstinence time, and accounted for spillage, minutes from ejaculation to analysis, and son's own smoking. We found no association between paternal preconceptional smoking and any of the semen parameters or testicular size. Adjustment for son's own smoking did not change results. While maternal plasma cotinine offers an objective measure of tobacco exposure and allows for a more thorough adjustment of maternal smoking, the high correlation between paternal pre-conceptional smoking and maternal cotinine exposure may, have resulted in overadjustment removing some paternal effect. Inability to distinguish between paternal never smokers and former smokers, may have led to misclassification of paternal pre-conceptional smoking and underestimation of associations. We found no support for an independent association between paternal pre-conceptional smoking and semen quality in young adult sons, but studies with more detailed paternal smoking history are needed before firm conclusions can be drawn.

Addiction-induced cognitive impairment, the case of methamphetamine

A documentary research was conducted to determine the relationship between methamphetamine abstinence time and cognitive performance in methamphetamine users. The purpose of this study is to know the existing difference between methamphetamine abstinence time and cognitive performance in a methamphetamine user population. The findings suggest significant differences in cognitive performance in methamphetamine withdrawal users compared to non-users. Particularly, a weakening of the prefrontal regions in charge of executive functions and a memory deficit correlated with dopamine deficits were observed. As for the altered functions, despite the heterogeneity of the results, we see that there is a low performance in inhibitory control, speed of execution and information processing. In addition to these deficits, there is also a problem in impulse control and social cognition.

Kanser hastalarında sperm kriyoprezervasyonu: 13 yıllık tecrübe

ABSTRACT&#x0D; Purpose: The study represents 13 years experience of sperm cryopreservation for different cancer types by researching the semen parameters, the use of frozen-stored samples in ART-ICSI (Assisted Reproductive Technologies-intracytoplasmic sperm injection) cycles, and their current storage status.&#x0D; Materials and Methods: Sperm cryopreservation in order to fertility preservation was conducted on 318 patients who had different malignancies applied to the Reproductive Center of Ankara Bilkent City Hospital (from November 2019 to April 2023) and Zekai Tahir Burak Women’s Health Hospital (from January 2010 to September 2019). The age, cancer type, semen volume, sperm count, sperm motility, samples storage status, and usage of banked sperm in ART cycles were recorded and analyzed.&#x0D; Results: Sperm cryopreservation was applied to a total of 318 patients for 13 years. The major cancer types of patients are testicular cancer (54.7%), lymphoma (17.3%), and leukemia (10.1%). 11% (n=35) of patients are under the age of 18 years old. The lowest sperm cryopreservation age at 14 years old in four patients. The highest median semen volume was detected in leukemia (3.1 (1.5-6.0)), and the lowest mean semen volume was in the urinary system tumor (1.5 (1.0-2.0)).In testicular cancer, the median(min-max) sperm concentration is 12.5 (1.0-100.0)×106/mL. In lymphoma, the median(min-max) sperm concentration is 40.0 (1.0-140.0)×106/mL. In leukemia, the median(min-max) sperm concentration is 24.5 (1.0-130.0)×106/mL. Sperm concentration significantly decreased in men with testicular cancer. The highest median of sperm motility was observed in nasopharyngeal tumor group (40.0 (20.0-60.0)). Compared to other cancer patients, individuals with leukemia (20.0 (2.0-55.0)) and urinary system tumors (8.0 (6.0-55.0)) showed lower sperm motility. Leukemia (20.0 (2.0-55.0)) The longest time of sexual abstinence was detected in leukemia 7.0 (1.0-25.0) and osteosarcoma (7.0 (3.0-10.0)). Four patients applied to our center to use their frozen sperm. The patients underwent five ART (ICSI) cycles and four embryo transfers. One of the patient had abnormal fertilization and one of the patient had twin clinical pregnancy. Three patients transferred their banked sperm to another center. Sperm samples of 277 patients continue to be stored in our fertility center.&#x0D; Conclusion: Since surgical methods, chemotherapy and radiotherapy treatments used for cancer treatment have intense negative effects on spermatogenesis and fertility health, sperm cryopreservation is the gold standard and increasingly being recommended in clinical practice for preserving the fertility potential of cancer patients before treatment.

Smoking relapse reasons among current smokers with previous cessation experience in Shanghai: A cross-sectional study.

Quitting smoking can lead to substantial health gains, even later in life. Many smokers who attempt to quit experience several relapses before achieving sustainable cessation. This study aims to ascertain the differences between quitters with short and long abstinence time and to explore relapse reasons among smokers with cessation experience in Shanghai. From January to December 2022, 1745 current smokers were recruited in Minhang, Jiading, Qingpu and Songjiang districts of Shanghai. We used an electronic questionnaire to collect data. We implemented logistic regression for odds ratio (OR) and 95% confidence interval (CI) calculation to explore factors associated with long cessation time among smokers with cessation experience of ≥3 months, ≥6 months, and ≥12 months. Of the 1745 smokers included, 1452 (83.2%) were males, with an average age of 44.2 years, and 48.0% (838/1745) had cessation experience but relapsed. Logistic regression indicated that smokers aged ≥45 years had a longer cessation duration (adjusted odds ratio, AOR=3.10; 95% CI: 1.97-4.88). Moreover, longer cessation duration among smokers was positively associated with low education level of junior high or lower (AOR=2.30; 95% CI: 1.42-3.72) and senior high (AOR=2.19; 95% CI: 1.53-3.15), older age at first tobacco smoking (AOR=1.62; 95% CI: 1.1.16-2.25), but was negatively associated with longer smoking duration (AOR=0.67; 95% CI: 0.43-0.00) and higher smoking burden (AOR=0.44; 95% CI: 0.28-0.72). The main reasons for cessation relapse were social interaction needs (34.5%) and discomfort due to abstinence (29.1%). The relapse rate was high among smokers even after 12 months of abstinence. Smokers with older age, lower education level, shorter smoking duration and lower tobacco burden had longer cessation duration. Social interaction needs and withdrawal symptoms were the main relapse reasons. It is highly recommended that health bureaux consistently conduct tobacco control initiatives to spread awareness about the detrimental effects of tobacco smoke and the advantages of quitting smoking, even after achieving cessation.

Trends in sperm quality by computer-assisted sperm analysis of 49,189 men during 2015-2021 in a fertility center from China.

Sperm quality, including semen volume, sperm count, concentration, and total and progressive motility (collectively, "semen parameters"), has declined in the recent decades. Computer-assisted sperm analysis (CASA) provides sperm kinematic parameters, and the temporal trends of which remain unclear. Our objective is to examine the temporal trend of both semen parameters and kinematic parameters in Shanghai, China, in the recent years. This retrospective study analyzed semen parameters and kinematic parameters of 49,819 men attending our reproductive center by using CASA during 2015-2021. The total sample was divided into two groups: samples that surpassed the WHO guideline (2010) low reference limits ("above reference limit" group, ARL; n = 24,575) and samples that did not ("below reference limit" group, BRL; n = 24,614). One-way analysis of variance, Kruskal-Wallis test, independent samples t-test, and covariance analysis were used to assess the differences among groups. Year, age, and abstinence time were included in the multiple linear regression model of the ARL group to adjust the confounders and depict the trends in sperm quality. Among all the total sample and the ARL and BRL groups, the age of subjects increased in recent years. Semen volume and sperm count showed declined tendency with years in the total sample, the ARL and BRL groups, and the subgroup of age or abstinence time, whereas sperm velocities showed increased tendency with years on the contrary. The multiple linear regression model of the ARL group, adjusting for age and abstinence time, confirmed these trends. Semen volume (β1= -0.162; CI: -0.172, -0.152), sperm count (β1= -9.97; CI: -10.813, -9.128), sperm concentration (β1 = -0.535; CI: -0.772, -0.299), motility (β1 = -1.751; CI: -1.830, -1.672), and progressive motility (β1 = -1.12; CI: -0.201, -0.145) decreased with year, whereas curvilinear line velocity (VCL) (β1=3.058; CI: 2.912, 3.203), straight line velocity (VSL) (β1=2.075; CI: 1.990, 2.161), and average path velocity (VAP) (β1=2.305; CI: 2.224, 2.386) increased over time (all p < 0.001). In addition, VCL, VSL, and VAP significantly declined with age and abstinence time. The semen parameters declined, whereas the kinematic parameters increased over the recent years. We propose that, although sperm count and motility declined over time, sperm motion velocity increased, suggesting a possible compensatory mechanism of male fertility.

O-015 Spontaneous alterations in semen parameters are associated with age, accessory gland function and the FSHB c.-211G&amp;gt;T variant

Abstract Study question Which parameters are associated with spontaneous alterations in semen analysis in infertile men? Summary answer Changes in semen parameters are modulated by abstinence time, accessory gland function and fluctuations in FSH serum concentration, which is bound to FSHB c.-211G&amp;gt;T variant. What is known already There is a strong within-subject alteration of semen parameters in men with infertility. The WHO therefore recommends two ejaculate analyses. However, it remains unknown in which subgroup variations are likely to occur and which semen parameters are affected. We assume that in some men with idiopathic infertility, ejaculate parameters may spontaneously change without interventional medication apart from regression to the mean effects. The study aims to identify factors in conventional semen analysis based on the patients’ clinical data, including reproductive hormones like follicle stimulating hormone (FSH), and factors impacting endocrine activity, like the FSHB-211 promoter gene. Study design, size, duration In this retrospective longitudinal study we selected 3456 deeply phenotyped men with idiopathic infertility who had visited our centre for fertility workup from 2010-2020. The patients were selected from our well curated database Androbase© for analysis of repeated ejaculate samples. Participants/materials, setting, methods Men with idiopathic infertility and at least two ejaculate analyses (70-90 days distance) were included. Exclusion criteria comprised: sperm concentration &amp;lt;1 million/ml, abnormal FSH or low testosterone, bitesticular volume (bTV) &amp;lt;10ml, orchiectomy, cryptorchidism, varicocele testis, oncological disease, genetic findings (i.e. abnormal karyotype, AZF deletions), medication affecting spermatogenesis. Grouped linear 2-level nested mixed-effect models were applied. Analyzed parameters included: somatic, hormonal (including FSH and FSHB c.-211 variants), and semen parameters (including abstinence time, accessory gland markers). Main results and the role of chance Groups were built according to sperm concentration: A (n = 397): ≥1.0 to &amp;lt; 5.0 mill/ml, B (n = 708): ≥5.0 to &amp;lt; 15.0 mill/ml, C (n = 2351): ≥15.0 mill/ml. A, B and C: changes in ejaculate volume were associated with alterations in total sperm count and motility (p &amp;lt; 0.003). Changes were, controlled for abstinence time (p &amp;lt; 0.001), related to alpha-glucosidase, fructose or zinc (p = 0.005-0.02). A+B: fluctuations in FSH concentration influenced sperm concentration/count (p = 0.004-0.02), albeit only in men with FSHB c.-211 GG (p = 0.007-0.02). T-allele carriers did not show changes in FSH concentration (p &amp;gt; 0.1). B: age &amp;lt;50 years (p = 0.007-0.01) and normal bTV (p = 0.008-0.02) were associated with spontaneous increases of sperm concentration, count and motility. Semen parameters exhibit intra-individual alterations associated with organic, hormonal and genetic variables. Changes are pronounced in younger men with normal bTV and oligo- to almost normozoospermia. The effect is modulated by abstinence time, accessory gland function and fluctuations in FSH concentrations which, in turn, are bound to the FSHB-211 promotor gene polymorphism. Limitations, reasons for caution A limitation of our approach is the retrospective nature of the study, which cannot exclude the possibility of bias within the data set. Wider implications of the findings Judgement of semen analysis should be based on two semen samples, with abstinence time between 4-5 days. In future clinical trials, abstinence time should be kept constant. It might be investigated if younger men with normal bTV and FSHB c.-211 GT/TT benefit from improving accessory gland function and increasing FSH. Trial registration number not applicable

P-062 The influence of the ejaculatory abstinence period on semen parameters from the first diagnostic sample – results from analysis of 14000 samples

Abstract Study question Is ejaculatory abstinence period (EAP) associated with semen parameters in males undergoing preliminary fertility investigation? Summary answer Short EAP is associated with increased progressive motility (%), vitality but with reduced volume, concentration, total sperm count. No association was indentified with morphology, DNA fragmentation. What is known already It is known that semen parameters may present important intra-individual variations. At present, the last edition of the WHO Manual recommends ejaculatory abstinence from two to seven days for semen analysis. Nonetheless, this period is not supported by some relevant bodies in the reproductive field guidelines that limit abstinence period to three or four days. Recently published reviews on this matter support that the relationship between the abstinence time and sperm quality is not straightforward. Therefore the aim of this study is to analyze correlation between the ejaculatory abstinence time and sperm parameters in patients having initial work-up in our clinic. Study design, size, duration We conducted a retrospective cross-sectional study on the diagnostic semen samples from individuals having their initial fertility investigation in the Fertility Department of a University Affiliated Hospital between the beginning of 1997 and the end of 2022. Basic semen parameters and sperm deoxyribonucleic acid (DNA) fragmentation were registered in 14067 and 784 samples respectively. Sperm morphology was analysed in 4812 samples. Participants/materials, setting, methods We included exclusively results from the first diagnostic semen sample from males of any age undergoing preliminary infertility work-up. All samples were produced on-site and analysed “ad hoc” for basic semen parameters (according to 6th Edition of WHO Manual) or/and sperm DNA fragmentation (Sperm Chromatin Dispersion test). Samples were divided according to EAP: ≤2(A-group); 2-7(B-group); &amp;gt;7 days (C-group) and compared with ANOVA. Additionally, Spearman Correlation was used to confirm correlation between EAP and sperm parameters. Main results and the role of chance Semen analysis was performed either completely manually (23.4%) or with the use of Computer Assisted Semen Analysis (CASA) system (76.6%) with the exception of morphology which was always assessed manually. Overall, 661 samples were produced after ≤2 days of abstinence, 12734 after 2 to maximum 7 days and 690 after &amp;gt;7 days of which ones 330(50%), 6798(53%) and 336(49%) were normozoospermic, respectively. Mean male age was 39 years (SD 6.5) and EAP 4.5 days (SD 1.9). We found the following parameters positively correlated with EAP in both normozoospermic and abnormal samples: volume (A-2.6ml; B-3.6ml; C-4ml, p &amp;lt; 0.05), concentration (A-72M/ml; B-93M/ml; C-127M/ml, p &amp;lt; 0.05), total sperm count (A-161M; B-285M; C-472M, p &amp;lt; 0.05), total motile count (A-111M; B-186M; C-270M, p &amp;lt; 0.05), straightness coefficient (STR) (A-73.1; B-75.7; C-77.8%, p &amp;lt; 0.05) and Zinc concentration (A-14277; B-17375; C-22538µg/dl, p &amp;lt; 0.05). The following parameters were negatively correlated with EAP in both normozoospermic and abnormal samples: progressive motility (A-46; B-43.6; C-36.6%, p &amp;lt; 0.05), vitality (A-60.5; B-60.3; C-53.7%, p &amp;lt; 0.05). We did not find any correlation with leucocytes, fructose, morphology or DNA fragmentation in unselected patients. However, in the group of abnormal samples there was a negative correlation between EAP and morphology (A-3.7; B-3.1; C-2.8%, p &amp;lt; 0.05) and DNA fragmentation, in generalized additive model (Spearman-Correlation, R2 0.01, p &amp;lt; 0.05). Limitations, reasons for caution This is a cross-sectional study which demonstrates only association and does not allow establishment of a cause-effect relationship between EAP and sperm parameters. Additionally, despite significant correlation between EAP and some sperm parameters, its clinical usefulness remains unclear. Wider implications of the findings To our knowledge this is first study correlating EAP with semen parameters only from diagnostic semen samples produced on-site, which confirms that the abstinence time should be seriously considered when analysing ejaculates, especially when borderline results are obtained. Additionally, different clinical strategies may be considered for normo and non-normozoospermic patients. Trial registration number not applicable

O-251 LIN28B gene expression is downregulated in spermatozoa of oligozoospermic men and associates with genetic variants previously linked to pubertal onset

Abstract Study question Is there an association between genetic polymorphisms in LIN28B with LIN28B expression and semen quality in spermatozoa from oligozoospermic men? Summary answer LIN28B is downregulated in spermatozoa of oligozoospermic men and explains 39% of sperm count variability. One SNP (rs314280) was associated with low LIN28B mRNA expression. What is known already Large-scale genomic studies have identified genetic variants in or near LIN28B to be robustly associated with pubertal traits such as age at menarche and age at voice break. The LIN28 family of genes are known to control cell division, growth and differentiation. The LIN28B orthologue is exclusively expressed at high levels in the testis and placenta; however, we have limited knowledge about the role of LIN28B in relationship to testicular function. Interestingly, other studies have showed that later onset of puberty is associated with poor semen quality, suggesting that pubertal development may influence adult testicular function. Study design, size, duration Twenty-nine oligozoospermic (cases) and fifty-four men with normal sperm concentration (controls) were recruited from patients seeking andrological work-up for male/couple infertility at a University Hospital. Subjects with abnormal karyotype, Yq-microdeletions, varicocele GIII-IV, hypogonadotropic hypogonadism, seminal infection, diabetes, BMI&amp;gt;35, excessive consumption of alcohol/drugs, testicular cancer, chemotherapy/radiotherapy were excluded. Semen samples were obtained for analysis (WHO, 2010) and sperm isolation by density gradient (PureSperm40®). Peripheral blood samples were analysed for reproductive hormones and used for DNA extraction. Participants/materials, setting, methods LIN28B and GAPDH-S mRNA abundance were measured by qRT-PCR (2-ΔCT method) in RNA isolated from purified sperm using SYBR® MasterMix (Takyon). Five SNPs in linkage disequilibrium (rs7759938, rs395962, rs314268, rs314277 and rs314280) were genotyped (TaqMan™ SNP Genotyping Assay). Statistical differences between groups were assessed by Mann-Whitney test and genetic association was analysed using “SNPassoc” package in R. Values are showed as median, Q1-Q3. Main results and the role of chance Cases and controls had similar age and BMI but as expected sperm concentration, morphology and vitality were differed between groups (9.9, 4.9-13.1 vs 82.8, 46.0-146.5 mill/ml; 1, 1-2 vs 3, 1-4% normal forms and 83%, 76-89 vs 86%, 82-90, respectively) (p &amp;lt; 0.05). No differences were observed in progressive motility, semen volume and days of abstinence. FSH and LH serum levels were higher in cases compared with controls (4.6, 2.6-7.8 vs 3.2, 2.5-4 mIU/ml and 4.2, 2.9-5.2 vs 3.1, 2.1-4.2 mIU/ml, respectively; p = 0.019 and p = 0.017). Relative expression of LIN28B was significantly diminished in cases compared with controls (0.0034, 0.0015-0.0103 vs 0.0446, 0.0122-0.1026; p &amp;lt; 0.001), while expression of the internal housekeeping control GAPDH-S was similar between groups. Linear regression model showed significant association of sperm concentration and total sperm count with LIN28B relative expression adjusted by age, abstinence time, % progressive motility and % normal morphology (beta=0.408, R2=0.241, p &amp;lt; 0.001 and beta=0.461, R2=0.393, p &amp;lt; 0.001). LIN28B rs314280 was associated with mRNA expression in the dominant model (p = 0.025) and two other SNPs (rs7759938, rs314268) showed the same trend (p = 0.09). Men with at least one minor allele of these 3 SNPs had a lower LIN28B mRNA abundance (p = 0.006; p = 0.07; p = 0.055). Limitations, reasons for caution Genotype frequency comparisons between cases and control were not conducted because of the small sample size. A larger cohort will be studied to address this assumption and association of genotypes with parameters of semen quality. Wider implications of the findings To our knowledge this study represents the first report on LIN28B expression and human testicular function. The significant direct association of LIN28B mRNA expression with sperm concentration suggests that LIN28B may be involved in spermatogonial proliferation. Trial registration number not applicable

P-019 Short ejaculatory abstinence time is associated with higher pregnancy and live birth rates and improved DNA fragmentation index (DFI): A Systematic Review

Abstract Study question Does short ejaculatory abstinence time (EA) improve DNA fragmentation and reproductive outcomes compared with long EA following assisted reproductive technology (ART)? Summary answer Shorter EA is associated with improved pregnancy and live birth rates following ART and lower DFI compared with longer EA at different cut-off points. What is known already When spermatozoa pass the epididymal tract, they are exposed to reactive oxygen species (ROS). ROS is known to cause DNA fragmentation. Testicular sperm has a lower DNA fragmentation when compared to ejaculated sperm, which indicates that DNA fragmentation is increased during the transition and storage in the epididymal duct. There are studies that suggest that a high DFI is associated with poor pregnancy and live birth rates following ART. WHO recommends 2-7 days of EA prior to semen collection; however, several recent studies have reported a correlation between shorter EA and improved reproductive outcomes and DFI. Study design, size, duration A systematic review was conducted according to the PRISMA guidelines and registered in PROSPERO (CRD42022379039). The electronic databases PubMed, Embase and Cochrane were searched for eligible studies by a research librarian in April 2022. Additional articles were manually retrieved after reviewing the reference lists from relevant publications. Participants/materials, setting, methods Two authors independently screened studies based on the eligibility criteria; studies including men referred to fertility treatment undergoing short and long EA reporting data on pregnancy rate, live birth rate and DFI. Study demographics, population characteristics and data on study outcomes including statistical analyses were extracted. Risk of bias in each study was evaluated according to The Scottish Intercollegiate Guidelines Network (SIGN). Any disagreements were resolved by a third author. Main results and the role of chance Out of 1237 studies initially identified, 24 of them met eligibility criteria and were included in the review with a total of 14.173 cases. The studies included in this review were conducted in Asia, North and South America and Europe. The cause of referral to fertility treatment includes both male, female, mixed and unexplained infertility. The EA varied from less than a one hour to as long as 15-20 days. Nine of the 13 studies investigated the influence of varying EA on pregnancy rate, found a significantly higher pregnancy rate with short EA compared with long EA, five with EA as short as one day or less. Three studies evaluated live birth rates and found a significantly higher live birth rate when comparing short EA with long EA. Eleven of the 15 studies that reported DFI found significantly lower DFI with short EA compared with long EA. EA of one day or less were associated with the lowest rates of DFI in the studies. In general, pregnancy rate, live birth rate and DNA fragmentation are likely to be improved with short EA compared to long EA. Limitations, reasons for caution Many of the included studies used different EA intervals, leading to heterogenous data, and therefore, only allowed limited conclusion to be formulated regarding the ideal timeframe of EA. Four studies scored poorly in SIGN methodology checklist due to confounding and population size, suggesting their findings to be treated with caution. Wider implications of the findings Even though it is difficult to make a clear recommendation on the ideal timeframe for EA because of the heterogenous abstinence periods, this review suggest decreasing the EA limits of 2-7 days as recommended by WHO to improve pregnancy rate and decrease DNA fragmentation in semen, followed by ART. Trial registration number not applicable