Frequent Ejaculation & Fertility: New Study Challenges Abstinence for Sperm Quality

Frequent ejaculation may improve male fertility by preventing DNA damage to sperm, according to a new meta-analysis of nearly 55,000 men. The research challenges longstanding guidelines recommending several days of abstinence before fertility testing or treatment, suggesting that prolonged periods without sexual activity can negatively impact sperm quality.

The study, published in Proceedings of the Royal Society B, combined data from 115 human studies and 56 studies on non-human species. Researchers found that sperm deteriorates over time even as stored within the male reproductive system, regardless of age. This deterioration manifests as increased DNA fragmentation and oxidative stress, reducing both sperm motility and viability.

“In men, the negative effects we found on sperm DNA damage and oxidative damage were large-ish, so we are confident that This represents a biologically meaningful and critical effect,” said Dr. Krish Sanghvi, a biologist at the University of Oxford and lead author of the study.

Current World Health Organization (WHO) guidelines advise men to abstain from ejaculation for two to seven days prior to providing a sperm sample for analysis or in vitro fertilization (IVF). These recommendations were initially designed to maximize sperm count, not necessarily sperm quality.

Sanghvi argues that this approach may need reevaluation. “All we recommend is that clinicians and couples reconsider whether long abstinence is always good, because abstinence leads to deterioration in sperm quality,” he stated. The study suggests a balance between sperm quantity and quality is crucial for optimal fertility outcomes.

Recent clinical trials support this assertion. A trial involving 453 couples demonstrated a significant difference in pregnancy rates based on abstinence duration. Couples where men abstained for less than two days achieved a 46% pregnancy rate, compared to 36% in those who abstained for two to seven days, according to research published on SSRN.

For couples attempting natural conception, finding the right balance is key. Too little abstinence may result in insufficient sperm count or maturity, while prolonged abstinence can lead to DNA damage and reduced motility. “For couples, our recommendation would be that longer abstinence is not always a good thing, and that a balance between quantity [and] quality needs to be struck,” Sanghvi said.

Experts in the field acknowledge the evolving understanding of sperm quality. Professor Allan Pacey, a professor of andrology at the University of Manchester, noted the growing evidence supporting shorter abstinence times for assisted reproductive technologies like IVF. “This is because with a short abstinence time the sperm are fresher, more motile and have lower levels of DNA damage,” he said.

Pacey clarified that the two-to-seven-day abstinence rule remains important for diagnostic semen analysis, allowing for consistent comparisons between laboratories. However, he emphasized that prioritizing fresh, healthy sperm is more critical during actual IVF treatment. “We can do IVF treatment with a low number of sperm, and even lower if we do ICSI (intracytoplasmic sperm injection), so it isn’t as necessary for men to save up their sperm in the way that we once thought.”

Sperm DNA fragmentation is a recognized factor in male infertility, impacting embryo development, implantation, and pregnancy outcomes, as noted in a recent article in Nature. Several methodologies exist to measure sperm DNA fragmentation, including the sperm chromatin structure assay and the TUNEL assay.