Generally speaking, specialists in reproductive medicine have customarily recommended that patients beginning a cycle of assisted human reproduction refrain from sexual activity while in treatment; this is the same as the guideline for men undergoing a sperm analysis – a test for which the male should have an abstinence of 2-5 days, as this allows us to ensure that the parameters obtained are comparable in different situations.
However, scientific evidence has shed light on this area of expertise, bringing about substantial change with the help of current data that has disproved this preconceived idea.
In this regard, recent scientific publications have demonstrated the benefits of ejaculating several times during the days prior to leaving the sperm sample for the laboratory. This is due to the fact that these ejaculations decrease the fragmentation of sperm DNA, thus guaranteeing that the spermatozoids obtained will have higher quality. Additionally, it is best for the male to have the final ejaculation as close as possible to the time of providing the sample for oocyte fertilisation in the laboratory.
Nevertheless, we must keep in mind that having several ejaculations means that we will obtain a lower volume of ejaculate and fewer spermatozoids. Therefore, for patients with severe oligospermia (less than 2 millon/ml) or hypospermia (less than 1.5 ml), the recommendation is to leave a sperm sample to be frozen, in advance, which could then be used in the event that there are no spermatozoids in the fresh sample provided on fertilisation day.
Additionally, embryo implantation in the endometrium is a process that requires mother-to-embryo immune tolerance, as the two are genetically different from each other. These immunological changes benefit from the interactions that occur among seminal fluid proteins. Thus, it is advisable to have sexual intercourse around the same time the oocytes are fertilised, as this increases the likelihood of achieving a viable pregnancy by about 24% compared with current rates. Easy, simple and effective.
It is for these reasons that we, as gynaecologists, must be very mindful of new scientific evidence, especially when speaking with patients during a consultation, so that we can work through any doubts or fears that may arise regarding these topics, and particularly so that patients may be aware of all the associated benefits.