Effect of ejaculatory abstinence period on sperm DNA fragmentation and pregnancy outcome of intrauterine insemination cycles: A prospective randomized study

Arch Gynecol Obstet. 2021 Jan;303(1):269-278. doi: 10.1007/s00404-020-05783-0. Epub 2020 Sep 9.

Abstract

Purpose: To evaluate the effect of the ejaculatory abstinence period on sperm DNA fragmentation and pregnancy rates in IUI cycles.

Methods: One hundred and twenty couples with unexplained infertility were prospectively randomized into two groups on the second day of their cycle. In group A, patients had 1-day ejaculatory abstinence period; in group B patients had 3-day ejaculatory abstinence period. Each patient was stimulated with gonadotropins, and IUI was performed. The primary outcome measure was clinical pregnancy and sperm DNA fragmentation rate.

Results: The pregnancy rate was 17.3% and 18.5% in group A and group B, respectively. No significant difference was found among the groups (p = 0.803). The sperm DNA fragmentation rate for group A (20.71 ± 11.01) and group B (23.78 ± 12.64) were almost similar (p = 0.187). The sperm DNA fragmentation rate was 24.89 ± 12.89 in pregnant couples and 21.71 ± 11.69 in non-pregnant couples (p = 0.288).

Conclusion: Even after a short abstinence period of 1 day, compared to the standard abstinence period of 3 days, pregnancy rates are similar among unexplained infertility couples undergoing ovarian stimulation and IUI.

Clinicaltrials: The study was registered at ClinicalTrials.gov with ID NCT04361292. Date of registration: 27 April 2020. The study was registered retrospectively.

Keywords: Ejaculatory abstinence; Intrauterine insemination; Semen analysis; Sperm DNA fragmentation; TUNEL assay.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • DNA / analysis*
  • DNA Fragmentation*
  • Ejaculation
  • Female
  • Fertilization in Vitro / methods*
  • Gonadotropins / administration & dosage
  • Humans
  • Infertility / therapy*
  • Insemination, Artificial
  • Male
  • Ovulation Induction
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Rate*
  • Prospective Studies
  • Spermatozoa
  • Treatment Outcome

Substances

  • Gonadotropins
  • DNA

Associated data

  • ClinicalTrials.gov/NCT04361292