A friend of Lilac Garden Forum posted for help: Abstinence for 2 days to do semen routine, the patient asked me to compensate for mental damage, what should I do?
Source: Lilac Garden ForumA patient over 30 years old said: ” The urologist said that he needs to abstain for at least 5 days before he can do semen routine. The patient came to me today with the instruction manual of semen collection and abstinence time from outside the hospital, saying that I took semen for analysis after 2 days of abstinence (more than 48 hours), and asked me to compensate. For the mental damage fee, if I don’t pay compensation, I will come to my clinic every day and cause me to be unable to work normally, so I would like to ask you all for help (2-7 days of abstinence written in the Andrology Guide edited by Professor Deng Chunhua), how should I respond to the patient’s request?” How many days of abstinence are required for routine semen test?
- relevant teaching materials and manuals are recommended for 2~7 days< /span>
For this reason, I checked the fifth edition of the basic textbook of clinical examination (edited by Liu Chengyu and Luo Chunli). The book states that the semen abstinence time is 2 to 7 days. Similarly, the World Health Organization (translated by Gu Yiqun, Chen Zhenwen, Lu Wenhong, etc.) mentioned in the laboratory manual on human semen testing and processing (5th edition) that semen collection recommends abstinence for 2 to 7 days. Source: Laboratory Manual for Human Semen Examination and Processing (5th Edition)
- Different medical institutions have certain adjustments
I consulted several local The hospital found that different medical institutions recommend different periods of abstinence for patients according to their own experience, including 2~7d, 2~5d, 3~5d, 3~7d, etc., and even different departments of the same medical institution (reproductive center and Urology) recommended abstinence times vary. Why is there a difference in abstinence time? This is mainly because different abstinence time has an important influence on the sperm quantity and quality of the collected semen samples. Each department has different needs for semen samples, so the abstinence time is adjusted.
- First look at the composition of semen< /strong>
Normal semen is a viscous liquid mixture consisting of sperm and seminal plasma, which makes up more than 90% of the semen volume. Sperm are produced by the testis, mature in the epididymis, and output through the vas deferens. In addition to a large amount of water, fructose, proteins and polypeptides, the seminal plasma also contains a variety of other carbohydrates (such as glucose), enzymes (eg prostaglandins), inorganic salts and small organic molecules. Normally speaking, it is necessary to abstain from sex for 2~7 days before semen examination, and use masturbation to collect semen.
WHO recommends dividing sperm motility into 4 grades:
1. Rapid forward motility (a grade: straight movement);
2. slow or sluggish forward movement (grade b: slow movement);
3. Non-forward movement (grade c: in situ movement);
4. immobile (grade d: inactivity).
WHO stipulates that sperm motility in normal fertility: within 60 minutes after ejaculation, a-grade sperm should be > 25%; or a+b-grade sperm The sum is >50%.
- Abstinence time affects sperm count and sperm physicochemical indicators span>
It is widely believed that sperm count is inversely related to sexual intercourse frequency, and that semen quality decreases with increasing ejaculation frequency. In fact, prolonged abstinence increases parameters of semen specimens (including total sperm count, concentration, volume) and indicators affecting sperm quality (including sperm DNA fragmentation rate, reactive oxygen species in semen, semen pH), Decreases the viability and morphology of semen specimens. Studies show that abstinence for 1-3 hours compared with 3-7 days of abstinence significantly reduces semen volume and total sperm count, but significantly increases sperm concentration and motile sperm count. The results of basic semen parameters of routine abstinence (3~7d) and short-term abstinence (1~3h), Source: Screenshot of the literature. Sperm motility, normal sperm morphology, acrosome reactive capacity and total antioxidant capacity were significantly increased after 1-3 hours of abstinence compared with 3-7 days of abstinence. Likewise, sperm mitochondrial membrane potential and high DNA stainability were increased. The sperm DNA fragmentation index decreased significantly after 1-3 hours of abstinence. However, sperm nucleoprotein maturity and reactive oxygen species were not significantly different between the two.
Routine abstinence (3~7d) and short-term abstinence (1~3h) sperm physicochemical index detection, Image source: Literature.
- The effect of abstinence time on in vitro fertilization and artificial insemination
Artificial insemination (IUI), in vitro fertilization (IVF) and their derived technologies are widely used in the treatment of infertility patients, and conventional assisted reproductive technologies are used to assist in pregnancy treatment When the man needs to provide a sufficient number of forward motile sperm. Relevant studies recruited subjects and collected sperm from abstinence for 1-3 hours and 3-7 days for in vitro sperm therapy. It was found that in the whole embryo cryopreservation cycle, the implantation rate, clinical pregnancy rate, and live birth rate of spermatozoa undergoing IV-ET treatment with abstinence for 1-3 hours increased by 10.8%, 20.4%, and 17.5%, respectively, compared with spermatozoa for 3-7 days of abstinence. . Clinical outcomes of embryo transfer in cryopreservation cycle aa means freezing recovery cycle The first frozen embryo recovery transfer after whole embryo freezing;Source: Screenshot of the literature.
- Effects of different abstinence time on patients with oligospermia and asthenozoospermia< /span>
In recent years, the incidence of male infertility has increased year by year, mainly manifested as oligospermia and weak sperm, which seriously affect the quality of life of patients. Relevant studies have randomly assigned oligospermia and asthenospermia patients to abstain from sex for 2-4 days and 5-7 days. It was found that the semen volume, total sperm count, sperm density, and grade a+b sperm of oligospermia patients abstained from sex for 2-4 days. The percentages were lower than those of 5-7 days of abstinence, while the normal sperm morphology rate was higher than that of 5-7 days of abstinence. Patients with oligospermia are mainly manifested as slow semen production and low semen quantity. With the prolongation of abstinence time, their semen quantity, total number of sperm and percentage of grade a+b sperm increase, although the rate of normal morphology decreases , but for oligospermia patients, the overall quality of semen is improved for 5-7 days of abstinence. Comparison of semen quality in patients with oligospermia at different abstinence timesThe total semen and sperm count of patients with asthenozoospermia were normal, showing abnormal semen motility and morphology. reduce. After 2-4 days of abstinence, the total sperm count and sperm density of patients with asthenozoospermia were lower than those of 5-7 days of abstinence, and the normal sperm morphology and the percentage of a+b sperm were higher than those of 5-7 days of abstinence. For patients with asthenozoospermia abstinence for 2-4 days, the overall quality of semen is better. Comparison of semen quality at different abstinence times in asthenospermia patients
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- Abstinence time also affects seminal citric acid
The citric acid in seminal plasma is almost entirely derived from the prostate, and citric acid can participate in maintaining the osmotic pressure of seminal plasma, which is related to sperm survival. Its function is to bind calcium ions, and by combining with calcium ions, it regulates the concentration of seminal plasma calcium ions, and affects the coagulation and liquefaction process of semen after ejaculation; it also acts as a prostatic acid phosphatase activator, thereby affecting sperm motility. Some studies examined the seminal plasma citric acid twice before and after to explore the effect of different abstinence time on the test results. The abstinence time of group A was 0 d, group B 1 d, group C 2 d, group D 3 d, and group E 4 d. The total concentration of citric acid in seminal plasma was measured on the whole. The test of citric acid in seminal plasma has an impact, so patients should try to control the time of abstinence during the test of citric acid in seminal plasma, especially when they are reexamined. Daily seminal plasma citric acid concentration, semen volume, seminal plasma citric acid concentration comparison
< /p>Source: Lilac Garden Inspection TimeEditor:yeah Reviewer:Xiao Ran