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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| Format: | Article |
| Language: | English |
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Korean Society for Sexual Medicine and Andrology
2025-07-01
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| 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. |
| format | Article |
| id | doaj-art-2294c06b2ce9443486d413a34b074643 |
| institution | Kabale University |
| issn | 2287-4208 2287-4690 |
| language | English |
| 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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