Role of sequential semen samples in infertile men candidates for assisted reproduction: A prospective study

Objective: To study the beneficial effect of repeated sequential ejaculation in infertile men who are candidates for assisted reproduction. Materials and methods: The study included a total of 237 infertile males attending our infertility and IVF center from January 2016 till December 2017. All patients were asked to provide two semen samples (1–3 h apart) after an abstinence period of 3–7 days. The two consecutive semen samples were analyzed according to the 2010 WHO criteria for semen analysis and their parameters were compared. Results: The mean age for our study group was 35.7 years (20–56 year). Of the 237 subjects, 157 showed oligoasthenozoospermia on their initial semen sample while the remaining 80 were azoospermic. A statistically significant difference was detected between the 2 sequential semen samples regarding all semen parameters except grade A motility. Despite the significant decrease in seminal volume by sequential sampling, there was a statistically significant increase in sperm concentration in the second ejaculate compared to the first (6.2 ± 0.61 versus 3.4 ± 0.52 million/mL, respectively, p = 0.016). The mean normal sperm morphology also demonstrated a significant increase (2.1 ± 1.8–5.1 ± 2.6%, p