الفهرس 
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Abstract
Objective: There has been a growing body of evidence on the improvement
of semen quality in sequential semen samples. The study aimed to verify this
finding and its implication in the assisted reproduction arena.
Design: A retrospective review of records
Materials and methods: The study included the records of 102 infertile males
with idiopathic asthenozoospermia or oligoasthenozoospermia attending the
Egyptian fertility and IVF Center from January 2014 till December 2014. All
the patients had been previously asked to provide two semen samples (1-3
hours apart) after an abstinence period of 3-7 days. The two consecutive semen
samples were analyzed according to 2010 WHO criteria for semen analysis and
their parameters compared.
Results: Average subject age was 34.3 years (22-53). Of 36 patients who
had zero sperm concentration in their first sample, 9 of them were able to
show mature sperm in their second sample (25%). Hence, these patients
were spared from performing surgical sperm retrieval whether for diagnostic
or therapeutic purposes. Mean seminal volume among the study group was
2.9 ±1.6 mL in the 1st sample, with a mean concentration of 3±5.4×106
sperm /mL and mean motility of 4.9±7.8%. Although second sample mean
seminal volume decreased significantly compared to 1st (1.5±0.9 mL), yet
we detected a statistically significant incline in the mean sperm
concentration (3.6±6.3×106 sperm /mL) and mean motility (6.7±9.7%) of 2nd
sample sperm (p<0.05).
Conclusions: The study highlights a significant benefit of requesting a
consecutive ejaculate sample shortly after the first in males with poor semen quality or no detectable sperm in yielding a better quality sample. Using this
method, urologists can update instructions regarding timed intercourse thus
improving chances of natural conception as well as avoiding the utilization of
sophisticated sperm processing techniques and the need for unnecessary
invasive surgical sperm retrieval techniques in cases attempting assisted
reproduction. Ultimately, patients can be spared from added financial, physical
and mental burdens of infertility treatments.
Keywords: male infertility, semen quality, sperm, consecutive ejaculates,
sequential samples.