Tur-Kaspa I, Maor Y, Levran D, Yonish M, Mashiach S, Dor J
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel.
Fertil Steril. 1994 Aug;62(2):370-5. doi: 10.1016/s0015-0282(16)56893-9.
To clarify how often infertile men should have intercourse to achieve conception, the effect of sequential ejaculation on total motile sperm counts was investigated.
Case-control study.
Infertility and IVF unit, tertiary care center.
Five hundred seventy-six men who produced two closely spaced sequential ejaculates.
The total motile sperm counts of the second ejaculates were compared with the total motile sperm counts of the first ejaculates.
In normospermic men (n = 359), the total motile sperm counts decreased significantly from 93 (18 to 601) (median [minimum to maximum] x 10(6)) in the first ejaculate to 42 (1.2 to 387) in the second ejaculate, produced 24 hours later. In contrast to the normospermic men, in the asthenospermic group (24 hours difference, n = 81) and in both oligospermic groups, (1 to 4 hours difference, n = 27; and 24 hours difference, n = 45), there were no significant changes in the total motile sperm counts (24 [5.9 to 229] versus 30 [0.8 to 150], 6 [0.8 to 18] versus 3.6 [0.1 to 63] and 13 [2.5 to 32] versus 10 [0.1 to 66], respectively). Moreover, in both oligoasthenospermic groups (1 to 4 hours difference, n = 23; and 24 hours difference, n = 41) the total motile sperm counts increased significantly (3.2 [0.6 to 7.9] versus 8 [0.4 to 48] and 4 [0.2 to 13] versus 4 [0.1 to 101], respectively). In all groups, pooling sequential ejaculates significantly increased the total motile sperm counts, over and above that of the first ejaculate, by 49% in the normospermic group, 95% in the asthenospermic group, 67% and 75% in the oligospermic groups (1 to 4 hours and 24 hours difference, respectively), and 233% and 139% in the oligoasthenospermic groups (1 to 4 hours and 24 hours difference, respectively).
Sequential ejaculation may overcome the impaired sperm transport causing low total motile sperm counts observed in some oligospermic and/or asthenospermic men. Most of these infertile men may significantly increase their fertility potential, assessed by the total motile sperm counts, either by pooling sequential ejaculates for IUI, GIFT, and IVF, or by having intercourse every day or even twice a day, at the time of ovulation.
为明确不育男性应多久进行一次性交以实现受孕，对连续射精对总活动精子数的影响进行了研究。
病例对照研究。
三级医疗中心的不孕不育与体外受精科。
576名能产生两次间隔紧密的连续射精的男性。
将第二次射精的总活动精子数与第一次射精的总活动精子数进行比较。
在精液正常的男性（n = 359）中，第一次射精时总活动精子数为93（18至601）（中位数[最小值至最大值]×10⁶），24小时后产生的第二次射精时降至42（1.2至387）。与精液正常的男性不同，在弱精子症组（间隔24小时，n = 81）以及两个少精子症组中（间隔1至4小时，n = 27；间隔24小时，n = 45），总活动精子数无显著变化（分别为24[5.9至229]对30[0.8至150]、6[0.8至18]对3.6[0.1至63]以及13[2.5至32]对10[0.1至66]）。此外，在两个少弱精子症组中（间隔1至4小时，n = 23；间隔24小时，n = 41），总活动精子数显著增加（分别为3.2[0.6至7.9]对8[0.4至48]以及4[0.2至13]对4[0.1至101]）。在所有组中，合并连续射精显著增加了总活动精子数，相较于第一次射精，精液正常组增加了49%，弱精子症组增加了95%，少精子症组（间隔1至4小时和间隔24小时）分别增加了67%和75%，少弱精子症组（间隔1至4小时和间隔24小时）分别增加了233%和139%。
连续射精可能克服某些少精子症和/或弱精子症男性中导致总活动精子数低的精子输送障碍。这些不育男性中的大多数，通过为宫腔内人工授精、配子输卵管内移植和体外受精合并连续射精，或在排卵时每天甚至每天两次进行性交，可通过总活动精子数评估显著提高其生育潜力。
