Impact of Shorter Abstinence Periods on Semen Parameters: A Systematic Review and Meta-Analysis

Purpose: The success of assisted reproductive technology (ART) relies heavily on semen parameters, and it is influenced by the length of the abstinence period. The World Health Organization (WHO) recommends a 2- to 7-day abstinence period. Even so, efficacy is still suboptimal. Thus, this study ai...

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Main Authors: Marco Raditya, Alice Hari Soejono, Mario Alfonsus Siswanto, Widi Atmoko, Rupin Shah, Ashok Agarwal, Gerhard Reinaldi Situmorang, Ponco Birowo, Nur Rasyid
Format: Article
Language:English
Published: Korean Society for Sexual Medicine and Andrology 2025-07-01
Series:The World Journal of Men's Health
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author Marco Raditya
Alice Hari Soejono
Mario Alfonsus Siswanto
Widi Atmoko
Rupin Shah
Ashok Agarwal
Gerhard Reinaldi Situmorang
Ponco Birowo
Nur Rasyid
author_facet Marco Raditya
Alice Hari Soejono
Mario Alfonsus Siswanto
Widi Atmoko
Rupin Shah
Ashok Agarwal
Gerhard Reinaldi Situmorang
Ponco Birowo
Nur Rasyid
author_sort Marco Raditya
collection DOAJ
description Purpose: The success of assisted reproductive technology (ART) relies heavily on semen parameters, and it is influenced by the length of the abstinence period. The World Health Organization (WHO) recommends a 2- to 7-day abstinence period. Even so, efficacy is still suboptimal. Thus, this study aims to determine whether shorter abstinence periods (<2 days) can improve semen parameters. Materials and Methods: This study is a systematic review and meta-analysis. A literature search was performed across five databases: PubMed, Embase, ProQuest, Scopus, and Wiley Online Library using the PICO format. Retrieved articles were assessed according to eligibility criteria and the PRISMA flow diagram. Those eligible for quantitative analysis were assessed using forest plots. Risks of bias were tested using the Newcastle-Ottawa Scale. Results: A total of 22 studies and 31,640 samples were included. Studies showed that short abstinence periods significantly reduced semen volume (mean difference [MD] -0.83, p<0.01), sperm concentration (MD -8.39, p<0.01), and DNA fragmentation (MD -3.82, p<0.01). No differences in sperm morphology were identified. Meanwhile, the overall effect for total (MD 2.30, p<0.05) and progressive motile sperm (MD 2.18, p<0.01) was significantly increased. Subgroup analysis on oligospermia patients revealed a significant increase in normal sperm morphology (MD 1.64, p<0.01) along with reduced DNA fragmentation (MD -3.30, p<0.05). However, no significant changes were seen among other sperm parameters. Conclusions: In conclusion, our findings suggest a shorter abstinence period could be beneficial due to its effect on sperm motility and DNA fragmentation. Additionally, oligospermia patients will benefit from improved sperm morphology. These findings can provide insight for future guidelines to promote a shorter abstinence period for improving ART outcomes.
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institution Kabale University
issn 2287-4208
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publishDate 2025-07-01
publisher Korean Society for Sexual Medicine and Andrology
record_format Article
series The World Journal of Men's Health
spelling doaj-art-2294c06b2ce9443486d413a34b0746432025-08-20T03:29:23ZengKorean Society for Sexual Medicine and AndrologyThe World Journal of Men's Health2287-42082287-46902025-07-0143356357910.5534/wjmh.240035Impact of Shorter Abstinence Periods on Semen Parameters: A Systematic Review and Meta-AnalysisMarco Raditya0https://orcid.org/0009-0002-2458-4795Alice Hari Soejono1https://orcid.org/0009-0004-1068-1759Mario Alfonsus Siswanto2https://orcid.org/0000-0002-0901-9184Widi Atmoko3https://orcid.org/0000-0002-7793-7083Rupin Shah4https://orcid.org/0000-0002-7868-5949Ashok Agarwal5https://orcid.org/0000-0003-0585-1026Gerhard Reinaldi Situmorang6https://orcid.org/0000-0002-3614-6779Ponco Birowo7https://orcid.org/0000-0003-2934-6753Nur Rasyid8https://orcid.org/0000-0003-4473-755XFaculty of Medicine, University of Indonesia, Jakarta, IndonesiaFaculty of Medicine, University of Indonesia, Jakarta, IndonesiaFaculty of Medicine, University of Indonesia, Jakarta, IndonesiaDepartment of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, University of Indonesia, Jakarta, IndonesiaGlobal Andrology Forum, American Center for Reproductive Medicine, Moreland Hills, OH, USAGlobal Andrology Forum, American Center for Reproductive Medicine, Moreland Hills, OH, USADepartment of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, University of Indonesia, Jakarta, IndonesiaDepartment of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, University of Indonesia, Jakarta, IndonesiaDepartment of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, University of Indonesia, Jakarta, IndonesiaPurpose: The success of assisted reproductive technology (ART) relies heavily on semen parameters, and it is influenced by the length of the abstinence period. The World Health Organization (WHO) recommends a 2- to 7-day abstinence period. Even so, efficacy is still suboptimal. Thus, this study aims to determine whether shorter abstinence periods (<2 days) can improve semen parameters. Materials and Methods: This study is a systematic review and meta-analysis. A literature search was performed across five databases: PubMed, Embase, ProQuest, Scopus, and Wiley Online Library using the PICO format. Retrieved articles were assessed according to eligibility criteria and the PRISMA flow diagram. Those eligible for quantitative analysis were assessed using forest plots. Risks of bias were tested using the Newcastle-Ottawa Scale. Results: A total of 22 studies and 31,640 samples were included. Studies showed that short abstinence periods significantly reduced semen volume (mean difference [MD] -0.83, p<0.01), sperm concentration (MD -8.39, p<0.01), and DNA fragmentation (MD -3.82, p<0.01). No differences in sperm morphology were identified. Meanwhile, the overall effect for total (MD 2.30, p<0.05) and progressive motile sperm (MD 2.18, p<0.01) was significantly increased. Subgroup analysis on oligospermia patients revealed a significant increase in normal sperm morphology (MD 1.64, p<0.01) along with reduced DNA fragmentation (MD -3.30, p<0.05). However, no significant changes were seen among other sperm parameters. Conclusions: In conclusion, our findings suggest a shorter abstinence period could be beneficial due to its effect on sperm motility and DNA fragmentation. Additionally, oligospermia patients will benefit from improved sperm morphology. These findings can provide insight for future guidelines to promote a shorter abstinence period for improving ART outcomes.dna fragmentationsemen analysissexual abstinencespermatozoa
spellingShingle Marco Raditya
Alice Hari Soejono
Mario Alfonsus Siswanto
Widi Atmoko
Rupin Shah
Ashok Agarwal
Gerhard Reinaldi Situmorang
Ponco Birowo
Nur Rasyid
Impact of Shorter Abstinence Periods on Semen Parameters: A Systematic Review and Meta-Analysis
The World Journal of Men's Health
dna fragmentation
semen analysis
sexual abstinence
spermatozoa
title Impact of Shorter Abstinence Periods on Semen Parameters: A Systematic Review and Meta-Analysis
title_full Impact of Shorter Abstinence Periods on Semen Parameters: A Systematic Review and Meta-Analysis
title_fullStr Impact of Shorter Abstinence Periods on Semen Parameters: A Systematic Review and Meta-Analysis
title_full_unstemmed Impact of Shorter Abstinence Periods on Semen Parameters: A Systematic Review and Meta-Analysis
title_short Impact of Shorter Abstinence Periods on Semen Parameters: A Systematic Review and Meta-Analysis
title_sort impact of shorter abstinence periods on semen parameters a systematic review and meta analysis
topic dna fragmentation
semen analysis
sexual abstinence
spermatozoa
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