Impact of ejaculatory abstinence period and semen characteristic on the reproductive outcomes after intracytoplasmic sperm injection.

OBJECTIVE: The prognostic of semen characteristics in intracytoplasmic sperm injection (ICSI) outcomes is not clear. Also, there is no evidence-based recommendation for the abstinence period before ICSI. So, we aimed to assess the influence of the abstinence period and semen characteristics on ICSI outcomes. METHODS: A total of 1003 fresh ICSI cycles were divided into six groups; group 1 (1-day abstinence), group 2 (2 days abstinence), group 3 (3 days abstinence), group 4 (4 days abstinence), group 5 (5 days abstinence), and group 6 (6-10 days abstinence). RESULTS: We showed that semen volume (p=0.0001) and total sperm count (p=0.005) were increased in the groups with higher abstinence periods. Other semen parameters did not significantly associate with the abstinence period. The percentage of progressively motile sperm was associated with fertilization rate (p=0.007), and the sperm morphology was associated with cleavage-stage embryo rate (p=0.036). No influence of abstinence or semen parameters on rates of pregnancies was observed. CONCLUSIONS: The abstinence period before ICSI can influence the semen volume and total sperm count, and possibly fertilization. Although the sperm with the highest quality are selected for ICSI, the percentages of progressively motile and morphologically normal sperm in the ejaculated semen have a predictive value for fertilization and cleavage rates after ICSI, respectively.

Efficacy of daily GnRH agonist for luteal phase support following GnRH agonist triggered ICSI cycles versus conventional strategy: A Randomized controlled trial.

OBJECTIVE: The use of gonadotropin-releasing hormone agonist (GnRHa) as an alternative for human chronic gonadotropin (hCG) trigger has potential benefits, but the optimal luteal phase support (LPS) following GnRHa trigger remains to be elucidated. We aimed to investigate a new strategy (daily GnRH agonist for LPS following GnRH agonist trigger) as an alternative for the conventional approach to the patients undergoing intracytoplasmic sperm injection (ICSI). METHODS: In this randomized controlled trial study, 44 ICSI patients were randomly assigned into two groups: group 1, patients received standard strategy (hCG trigger [10000 IU] and progesterone bid [400 mg/BD] for LPS); group 2, patients received a dose of GnRHa (0.2 mg) for ovulation trigger and subcutaneous injection of GnRHa bid (0.2 mg) for LPS. RESULTS: The pregnancy, miscarriage, and live birth rates for the patients undergoing LPS following the GnRHa trigger were similar to those of patients undergoing the standard strategy. CONCLUSIONS: We showed that a daily subcutaneous injection of GnRHa for LPS following the GnRHa trigger can be successfully performed as an alternative to the standard strategy, with comparable pregnancy and live birth rates in ICSI patients.