Those of you who have been through IVF know that on the day of the procedure the male partner has to have between 2 and 5 days of sexual abstinence. The same is true if the man is going for semen analysis. What actually happens in the male body in those 2 to 5 days? Is there a connection between sexual abstinence in men and pregnancy rate?

Unlike ovulation in women, which is cyclical (usually once every 28 days), spermatogenesis is a constant process. Spermatozoa are stored in the epididymis and during ejaculation mix with secretions from the male accessory glands. These include mainly the prostate and seminal vesicles. It is logical to assume that the longer the period of sexual abstinence in a man, the more sperm will accumulate. However, the World Health Organization (WHO) reference values for sperm concentration, motility and morphology were determined for 2 to 5 days of abstinence. The reason is that this abstinence period is within physiological limits. Outside those limits the sperm accumulated in the epididymis could overflow and is flushed with urine.

There is some evidence that abstinence longer than the mentioned above could result in deterioration of sperm quality, in spite of the fact that semen volume and sperm concentration are usually higher. This deterioration is thought to be due to an increase in DNA fragmentation. It is hypothesized that when sperm are stored in the epididymis for long periods of time, they are exposed to free radicals, which increase the percentage of sperm with fragmented DNA. As the smallest cell in the human body with a very small amount of cytoplasm, the spermatozoon has limited mechanisms for neutralization of free radicals. Therefore, it is not recommended for spermatozoa to be left for a long time in the epididymis or once they are ejaculated.

According to a study published in 2017 in the prestigious American journal Fertility and Sterility, IVF cycles in which the male partner had less than 5 days of abstinence have on average higher pregnancy and live birth rates.



Sperm freezing allows long term storage and later use of your spermatozoa.

  1. Men or teenage boys who are about to undergo a treatment toxic to their spermatozoa. In most cases this is chemotherapy or radiotherapy. In 2018 the Center for Assisted Reproduction, governmental body providing funding for IVF, started funding egg freezing for medical reasons, as well as the subsequent IVF procedure. The purpose of this new policy is to allow women below 35, diagnosed with cancer, to preserve their fertility following chemo/radiotherapy. Unfortunately, the government does not fund sperm freezing for men with cancer. In spite of this, men must be informed of the option for fertility preservation well in advance of the start of their chemo/radiotherapy.
Men/teenage boys who are about to undergo pelvic or testicular surgery should also be advised to freeze sperm for the purpose of fertility preservation. The same is true for men, whose jobs could negatively influence their sperm quality (e.g. exposure to heavy metals, irradiation or high temperature).
  1. Men who will be absent/ abroad on the day of the IVF procedure. Whether due to work or other commitments, sometimes the male partner cannot be present on the day of the procedure. In such cases, having frozen specimen(s) is the only way to do the procedure. It is important to know that fresh sperm is always better than frozen due to the fact that some of the spermatozoa do not survive the freezing process. Therefore, frozen material is used only when there is no alternative.
  2. Men with very low sperm parameters or those having difficulty with ejaculation. This is especially important for men who sometimes have no sperm in their ejaculate. Even if other times there are single spermatozoa in the ejaculate, spermatozoa are frozen before the procedure as a back-up. Men with diabetes or other conditions causing erectile dysfunction are also advised to have back-up frozen sperm on the day of the IVF procedure.