FREQUENCY MATTERS: UNRAVELING THE ASSOCIATION BETWEEN EJACULATORY FREQUENCY AND SPERM QUALITY

Abstract

Background: Male infertility contributes to nearly half of all infertility cases worldwide. Semen quality is influenced by several factors, including the duration of sexual abstinence before ejaculation. Determining the optimal ejaculatory frequency may improve fertility assessment and reproductive outcomes. Objectives: To evaluate the effect of ejaculatory frequency on semen parameters and identify the abstinence period associated with optimal sperm quality. Methods: This observational study was conducted in the Department of Pathology at SBMCH, and included men aged 20–50 years undergoing fertility evaluation or voluntary semen donation. Participants were categorized according to abstinence duration: 1 day, 2–3 days, 4–5 days, and ≥6 days. Semen samples were analyzed for volume, sperm concentration, total sperm count, progressive motility, and morphology. Individuals with genitourinary disorders, chronic illnesses, substance use, or factors affecting spermatogenesis were excluded. Results: Semen volume, sperm concentration, and total sperm count increased significantly with longer abstinence periods (p<0.05). Mean semen volume increased from 1.8 ± 0.4 mL after 1 day of abstinence to 3.5 ± 0.7 mL after ≥6 days. Similarly, sperm concentration rose from 32.4 ± 8.2 to 55.9 ± 14.1 million/mL. However, progressive motility declined from 68.2 ± 7.3% to 53.7 ± 6.2%, while normal morphology decreased from 6.4 ± 1.2% to 5.4 ± 1.2% with increasing abstinence duration. Conclusion: Ejaculatory frequency significantly influences semen quality. Although prolonged abstinence increases semen volume and sperm count, a moderate abstinence period of 2–3 days provides the best balance between sperm quantity and functional quality, making it the optimal interval for fertility evaluation and assisted reproductive procedures.