Two subsequent seminal productions: a good strategy to treat very severe oligoasthenoteratozoospermic (OAT) infertile couples.

Ciotti, Patrizia Maria; Calza, Nilla; Zuffa, Silvia; Notarangelo, Leonardo; Nardi, Elena; Damiano, Giuseppe; Cipriani, Linda; Porcu, Eleonora

BACKGROUND sexual abstinence is considered one of the several factors that influence sperm quality. Recent studies show that a shortening of the abstinence period could be beneficial mostly in oligoasthenoteratozoospermic (OAT) patients. OBJECTIVE retrospective study to verify the efficacy of a second semen sample after a short abstinence to treat severe OAT infertile patients. MATERIALS AND METHODS 127 couples treated between May 2014 and May 2018 were divided into two groups. Study Group 1 (75 cycles): severe OAT characteristics: count < 0.2x106 /ml no progressive motility; count ≥ 0.2x106 /ml and no total or progressive motility; 0% normal morphology; a second semen sample was requested after abstinence of two hours. Control Group 0 (52 cycles): normozoospermic or mild OAT; only one sample was requested. Intracytoplasmic Sperm Injection was utilized in all cases. RESULTS all semen parameters were significantly different between Group 0 vs both samples of Group 1 (P<.001), excluding volume between Group 0 and 1st sample of Group 1 (P=.682). The comparison between 1st and 2nd samples from Group 1 showed significant differences in volume, total and progressive motility and morphology (P<.001, P<.001, P<.020) but not in total sperm count (P= .970). Fertilization, pregnancy rate/transfer, implantation and miscarriage rates were 85.9% and 61.1% (P< .001), 30.6% and 35.8% (P= .700), 17.5% and 24.0 (P= .292), 20.0% and 25.0% (P= .017) in Group 0 and Group 1 respectively. DISCUSSION AND CONCLUSION the results show that a short abstinence in severe OAT patients allows us to obtain sperm with better motility. The request for a second semen sample in couples with extreme semen parameters is a valid and simple strategy that helps to achieve the same probability of pregnancy compared to a Control Group. Furthermore, it allows us to utilize fresh sperms avoiding the need to resort to cryopreserved reserves or testicular surgery.