Goodbye to sexual abstinence in ART?: study disproves its direct relationship with fertilization and embryo quality

• There is controversy regarding the role of ejaculatory abstinence in sperm quality and its fertilizing ability, or embryo quality. Recent studies have highlighted the positive effects of short abstinence periods to prevent loss of motility and increased DNA fragmentation in sperm
• In this context, a recent study suggested that prolonged abstinence could reduce the fertilization rate in ICSI cycles without time-lapse imaging, thereby reducing the rate of usable zygotes
• A study presented by IVI at ESHRE demonstrates that ejaculatory abstinence—whether long or short—is not a relevant factor in reproductive outcomes and concludes that it is not associated with better embryo quality in IVF or ICSI cases

Amsterdam, JULY 08th, 2024

Is ejaculatory abstinence (EA) associated with fertilization and blastocyst development in ICSI (intracytoplasmic sperm injection) cycles using time-lapse incubators? Contrary to what some studies in the scientific literature suggested, a recent investigation presented by IVI at the 40th Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE), with a larger number of cases and more precise statistical analyses, has shown that abstinence is not a relevant factor for improving reproductive outcomes, neither in terms of fertilization nor blastocyst development or morphology.

“The study analyzes the relationship between embryo quality and the days of abstinence without ejaculation in men. The World Health Organization (WHO) recommendations for semen analysis and sample collection indicate that sexual abstinence should be maintained for between 2 and 7 days. However, in the case of assisted reproduction treatments such as IVF or ICSI, which require few sperm, several studies suggested that shorter abstinence periods resulted in better semen quality, as the sperm are younger and maintain their vigor and DNA integrity”, explains Dr. Nicolás Garrido, Director of the IVI Foundation.

The study ‘Ejaculatory abstinence: is there any association with embryo developmental competence? A Retrospective Study in time-lapse incubators’, presented at ESHRE, sheds light on this issue, which previous research had not conclusively clarified.

Semen analysis was conducted using WHO criteria for count, motility, and morphology, and all fertilized oocytes were cultured to the blastocyst stage in EmbryoScope or GERI incubators with continuous medium and refreshment on day 5 (if necessary). However, the days of ejaculatory abstinence (1-8 days) showed no association with fertilization or blastocyst development per mature oocyte, nor with abnormal fertilization.

As Dr. Garrido explains, “This is an interesting study that puts an end to the existing controversy about the usefulness of ejaculatory abstinence. It is well-executed from both an epidemiological and methodological standpoint, utilizing time-lapse incubators to improve the accuracy of fertilization checks and benefit from an undisturbed embryo culture environment”.

About IVI RMA Global

IVI was established in 1990 as the first medical institution in Spain dedicated exclusively to Human Reproduction. Since then, it has helped bring over 250,000 children into the world through continuous innovation and the implementation of the most advanced assisted reproduction treatments.

It is one of the European centers with the highest pregnancy rates; in fact, the majority of couples who consult IVI for infertility issues achieve their goal. Moreover, it boasts a team of over 2,500 professionals, including some of the world’s leading specialists in assisted reproduction.

IVI is part of the IVI RMA Global group, present in 15 countries. In addition to Spain, it has clinics in Portugal, Italy, the Czech Republic, the Nordic countries, the United Kingdom, the USA, Canada, Panama, Brazil, and Chile.