Halim Binarwan, Angellee Jesselyn, Agustinus Agustinus, Pakpahan Cennikon, Lubis Hilma Putri
Faculty of Medicine, Universitas Prima Indonesia, Medan, Indonesia.
Department of Obstetrics and Gynecology, Division of Reproductive, Endocrinology and Infertility, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatra, Indonesia.
J Reprod Infertil. 2024 Oct-Dec;25(4):281-289. doi: 10.18502/jri.v25i4.18126.
Longer abstinence time is believed to be associated with the production of reactive oxygen species (ROS), which in excessive amounts may be detrimental to the sperm. To enhance sperm quality, multiple research studies have proposed reducing the duration of abstinence by encouraging consecutive ejaculations. This approach has been shown to improve sperm motility and morphology, which are associated with better ICSI and IUI outcomes. The purpose of the current study was to evaluate sperm quality and fertilization rate, cleavage rate, as well as embryo quality in severe oligoasthenozoospermic men using the consecutive ejaculate collected within an hour of abstinence.
A prospective study was conducted at Halim Fertility Center from August 2020-April 2022, involving male partners undergoing ICSI treatment who presented with severe oligoasthenozoospermia on their previous semen analysis. The non-parametric Mann-Whitney and Wilcoxon tests were used to analyze the parameters of the groups, including characteristics of the study participants, oocytes and sperm samples, as well as the ICSI outcomes, using a significance level of 5%.
A statistically significant improvement in the sperm total motility was recorded in the consecutive ejaculate compared to the first (31.53±11.73% . 22.52±8.85%; p<0.001). Both fertilization and cleavage rates were higher in the consecutive ejaculate group, although they were not statistically significant (61.41±28.04% . 55.45±31.76%; p=0.081 and 88.10±28.63% . 81.07±36.34%; p=0.262).
Consecutive ejaculates collected within an hour of the first may enhance sperm total motility, fertility, and cleavage rates in male partners with low sperm count and quality undergoing ICSI treatment.
较长的禁欲时间被认为与活性氧（ROS）的产生有关，过量的ROS可能对精子有害。为了提高精子质量，多项研究提出通过鼓励连续射精来缩短禁欲时间。这种方法已被证明可以改善精子活力和形态，而精子活力和形态与更好的卵胞浆内单精子注射（ICSI）和宫腔内人工授精（IUI）结果相关。本研究的目的是使用禁欲一小时内收集的连续射精样本，评估重度少弱精子症男性的精子质量、受精率、卵裂率以及胚胎质量。
2020年8月至2022年4月在哈利姆生育中心进行了一项前瞻性研究，纳入接受ICSI治疗的男性伴侣，他们之前的精液分析显示为重度少弱精子症。使用非参数曼-惠特尼检验和威尔科克森检验分析各组参数，包括研究参与者、卵母细胞和精子样本的特征以及ICSI结果，显著性水平设定为5%。
与首次射精相比，连续射精样本的精子总活力有统计学意义的提高（31.53±11.73% 对22.52±8.85%；p<0.001）。连续射精组的受精率和卵裂率均较高，尽管无统计学意义（61.41±28.04% 对55.45±31.76%；p=0.081和88.10±28.63% 对81.07±36.34%；p=0.262）。
在首次射精后一小时内收集的连续射精样本，可能会提高接受ICSI治疗且精子数量和质量较低的男性伴侣的精子总活力、受精率和卵裂率。
