Evidence map›Paper›PMID 33179134›Full record

ArticleJournal of assisted reproduction and genetics2021

Three hour abstinence as a treatment for high sperm DNA fragmentation: a prospective cohort study.

Michael H Dahan, Ginevra Mills, Rabea Khoudja, Abbie Gagnon, Grace Tan, Seang Lin Tan

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of assisted reproduction and genetics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
3.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.

  1. Pooled it
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  7. Sperm DNA Fragmentation and Fertility.Advances in experimental medicine and biology · 2025
    Review
  8. Review
  9. Effects of a short abstinence period on sperm quality in oligozoospermic men.Clinical and experimental reproductive medicine · 2023
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Michael H DahanDepartment of Obstetrics and Gynecology, McGill University Health Centre, Montreal, QC, Canada. dahanhaim@hotmail.com.ORCID http://orcid.org/0000-0002-8121-7708
Ginevra MillsUniversity of Alberta, Calgary, AB, Canada.
Rabea KhoudjaOriginElle fertility Clinic, 2110 Boul. Decarie, Montreal, QC, Canada.
Abbie GagnonOriginElle fertility Clinic, 2110 Boul. Decarie, Montreal, QC, Canada.
Grace TanOriginElle fertility Clinic, 2110 Boul. Decarie, Montreal, QC, Canada.
Seang Lin TanDepartment of Obstetrics and Gynecology, McGill University Health Centre, Montreal, QC, Canada.
Ottawa Fertility Centre · CAMcGill University Health Centre · CAUniversity of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study sought to compare sperm DNA fragmentation (SDF) in semen specimens after 3 days and then after 3 h of abstinence in men presenting for initial infertility evaluation.

methodsA prospective cohort study of 112 men undergoing their first semen analysis as part of an infertility work-up was conducted. All participants presented with 3 days of abstinence for a semen analysis and DNA-fragmentation test. Both tests were repeated on a second sample collected 3 h after the first ejaculation. DNA-fragmentation was evaluated with the halo test by one of two technicians blinded to duration of abstinence. Variables analyzed include ejaculate volume, sperm concentration and motility, smoking status, cannabis use, initial specimen DNA fragmentation, and use of sperm-directed anti-oxidant formulations.

resultsAmong all subjects, DNA fragmentation improved in the 3-h abstinence specimen (34.6 ± 19.4% vs. 23.7 ± 16.0%, p = 0.0001). Among subjects with high DNA fragmentation (> 35%) on the initial specimen, 55% improved into the normal range. Semen volume and sperm concentration decreased (3.1 ± 3.3 ml vs. 1.9 ± 0.8 ml, p < 0.01 and 41 ± 39 vs. 32 ± 31 (millions/ml), p = 0.01), while progressive motility tended to increase. Fifty-eight subjects demonstrated ≥ 30% improvement in SDF in the second specimen as compared to the first. Factors found to correlate with > 30% improvement in DNA fragmentation in the 3-h abstinence specimen compared to 3 days were younger age and use of anti-oxidants.

conclusionHigh SDF can often be managed with a second ejaculation 3 h after the first in infertile couples, including in males with abnormal semen analyses per the 2010 WHO guide. Apart from SDF levels, changes in sperm quality were not clinically significant in the second specimen and did not increase rates of ICSI. However, a second ejaculation after 3 h probably may reduce the necessity of costly and/or invasive ART strategies.

Indexed as

DNA FragmentationAdultEjaculationFemaleHumansInfertility, MaleMaleProspective StudiesSemen AnalysisSexual AbstinenceSpermatozoaSperm CountSperm Injections, IntracytoplasmicSperm MotilityAbstinenceDNA fragmentationIUIIVFSemen analysis

Identifiers

PMID33179134
PMCPMC7822978
OpenAlexW3098450262

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.