Association of abstinence time with semen quality in men who undergoing fertility evaluation: a cross-sectional study from 3052 participants

Abstract

Objective: Abstinence time has been associated with semen quality, but the results remain controversial. Methods: This study recruited 3052 men undergoing fertility evaluation. Abstinence time (AT) was categorized as short (0-1 day), WHO-recommended (2-7 days) and long (>7 days). Semen parameters including volume, sperm concentration, progressive motility, total motility, total motility sperm count (TMSC), morphology and DNA fragmentation index were assessed for their association with AT. Results: Short AT was significantly associated with lower semen volume (P< 0.001), sperm concentration (P= 0.01) and TMSC (P< 0.001), while long AT was significantly associated with higher sperm concentration (P= 0.006), reduced progressive motility (P= 0.005) and total motility (P= 0.02), and higher DFI (P< 0.001). Restricted cubic spline models demonstrated a non-linear relationship between AT and the risk of low semen volume (Pnon-linear < 0.001), sperm concentration (Pnon-linear = 0.039) and TMSC (Pnon-linear < 0.001). Conclusions: Our findings suggest both short and long AT were significantly associated with lower sperm quality, which indicated the importance of maintaining a recommended AT (2-7days) for semen analysis. Additionally, short abstinence periods may be recommended to maintain optimal sperm DNA integrity.