January 17th, 2021

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Short-Interval Second Ejaculation: A Strategy to Reduce the Usage of Intracytoplasmic Sperm Injection in Assisted Reproductive Treatment
Authors:  Zhengda Li, M.D., Lintao Xue, Ph.D., Shikai Wang, M.D., Xianbao Mao, M.D., Xiaohui Zhang, M.D., and Pingpin Wei, M.D.
  OBJECTIVE: To evaluate whether short-interval second ejaculation could be applied clinically to reduce the usage of unnecessary intracytoplasmic sperm injection (ICSI).

STUDY DESIGN: Thirty-nine couples undergoing invitro fertilization (IVF) treatment were asked to provide a second ejaculate when the sperm quality of the first sample did not reach the requirement for IVF insemination. The semen parameters of the 2 ejaculate samples were compared. Other IVF cycles of non-secondary ejaculation on the same days of oocyte retrieval were set as the control group. The effects of the second ejaculate samples on fertilization, subsequent embryo development, and pregnancy outcome were analyzed.

RESULTS: There was lower semen volume (p<0.05) but higher sperm motility and speed parameters (p< 0.05) in the second ejaculate as compared with the first ejaculate. Finally, 13 couples (33.33%, 13/39) implemented IVF for the improvement of semen quality, and the resulting rescue ICSI ratio was similar to that of the control group (7.69% [1/13] vs. 10.17% [6/59], p> 0.05). Moreover, no significant difference was observed in the parameters of fertilization, embryo development, and pregnancy outcome as compared with the control group (p>0.05).

CONCLUSION: Short-interval second ejaculation can improve semen quality and reduce the usage of unnecessary ICSI.
Keywords:  assisted reproductive technology, invitro fertilization, ICSI, intracytoplasmic sperm injection, IVF, pregnancy outcome, semen analysis, short-interval second ejaculation, sperm quality
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