If you and your partner have decided to have a child, and you want to prepare well, it is a good idea to start with the conception.
The deep sense of conception
Since ancient times, the process of conception is shrouded in rituals, beliefs and superstitions. Popular science articles on this topic are increasingly common, but despite this, women are still accused of infertility without examining their partner. Today I will answer the question: should a man abstain from sex and masturbation and why.
Let me remind you that the probability of conception directly depends not only on women, but also on the fertility of men.
What determines a man’s ability to conceive?
Male fertility is the ability of a man to fertilize an egg and give healthy offspring. This concept includes male power – erection and sperm quality (its quantity and sperm motility).
As well as sexual constitution, fertility can be high, medium and low. Using a spermogram the lab identifies one of the two fertility indices. They show the probability of fertilization of an egg by a man’s sperm during one sexual intercourse.
- Kruger index. During the calculation, the size of the head, tail and neck of the sperm is determined and the ratio of healthy sperm to those with defects is calculated. The prognosis for natural conception is favorable if the Kruger index is more than 30%. The percentage of “ideal” sperm forms (PIF – percentage of ideal forms) is also calculated. PIF values of more than 4% are considered normal;
- Farris index. Indicates the percentage of motile, inactive and immobile sperm in the total volume of semen and in 1 ml. The index value of 20-25 is considered normal. Below – fertility is reduced, above – increased.
What affects fertility?
- Some medications;
- Bad habits, like beer;
- Chronic diseases (diabetes, hypertension, atherosclerosis, which are now getting younger);
- Overheating or prolonged squeezing of the testicles (impaired spermatogenesis);
- Deficiency of vitamins and minerals;
- Genital organs’ injuries (take care of intimate organs from childhood, teach boys not to hit in the panties area);
- Extra weight – a factor influencing the development of cardiovascular diseases. Also, adipose tissue accumulates female hormones;
- Age – the production of testosterone decreases, and as a result, the quality of erection goes down and the production of quality sperm decreases. But a man and a professional andrologist together may turn back the clock;
- Inflammatory and infectious diseases of the reproductive system. For example, if a boy is not vaccinated against mumps in time, it can lead to the loss of cells that will produce sperm in the future.
Adjusting lifestyle and habits, a man can achieve a significant improvement in spermogram results. It takes an average of 70-75 days to fully restore cells, so there are recommendations to prepare for conception for 3 months. During this time, it is important to establish a healthy diet, sleep, moderate exercise, start taking folic acid, quit smoking and excessive alcohol consumption. At the beginning of planning, it is important to visit an urologist-andrologist to exclude diseases of the genitourinary system, as well as to receive recommendations.
And what about no sex?
When a couple is planning a pregnancy on their own, it is important to have sex every 2-3 days, at least. Scientific communities are increasingly coming to the conclusion about the dangers of prolonged time without sex: the volume and concentration of sperm increase, but the motility and viability of sperm decreases.
The American Society for Reproductive Medicine questions the role of refusing from sex in the treatment of male infertility. In the study, the best sperm samples from patients with male infertility were obtained during sperm collection after only 2 days of sexual abstinence. An important criterion was the optimal condition of the genetic material. The prostate secretion contains a lot of zinc, and the seminal fluid contains proteins with high affinity for zinc. This element stabilizes the chromatin in the sperm heads (the same genetic material).
During frequent ejaculation, the fluid containing zinc becomes less, because it takes time to produce it, and the number of immature sperm increases. Poorly condensed chromatin is more vulnerable to potentially harmful effects of changing environmental factors (e.g. peroxidation).
Is it necessary to refrain from ejaculation for the sake of conception?
Patients with a normal semen analysis or sperm donors for cryopreservation are not allowed to abstain from ejaculation for more than 7 days, as DNA fragmentation occurs in spermatozoa.
In the study, where the reproductive technology method used was intracytoplasmic sperm injection (ICSI), men were asked to abstain from ejaculation for 4 days and then ejaculate once a day for 4 days, followed by an abstinence period of 12 hours. Compared to the control group, in which men abstained for only 4 days, the sperm count was found to decrease, but there was no difference in sperm motility or concentration. Also, in the group where men ejaculated, pregnancy occurred more often. Similar results were shown in a study that aimed to prove that prolonged abstinence leads to DNA fragmentation. After a short abstinence of up to 5 days, the genetic material was more stable. After ICSI, better embryo quality and a higher pregnancy rate were also noted comparing to the group with prolonged abstinence.
However, these data relate to assisted reproductive technologies, not natural planning.
What stands on the sperms way to conception
It is worth noting that sperm are quite sensitive to changes in the environment in which they are located. For example, acidity above or below 7.0-8.4 has a detrimental effect on cells. Another important indicator is the physiological osmolarity, which is approximately 320 mOsm/kg. If the fluid osmolarity is above 400 mOsm/kg, sperm motility is reduced by 50%.
Lubricating gels in the form of lubricants and ultrasound gels are used to reduce vaginal dryness for comfort during intimacy and in the clinic to facilitate the insertion of medical devices. They usually contain harmless ingredients such as glycerin or propylene glycol. Because the gels do not contain chemical spermicides, they are labeled as non-spermicidal. However, most of these gels have low pH and high osmolarity (almost 1000 mOsm/kg), which makes them “uncomfortable” for sperm. In fact, studies have shown that lubricants and some ultrasonic gels can have a toxic effect on sperm and are contraindicated for couples trying to conceive.
The same can be said about using saliva for moisturizing. Despite the optimal acidity, it is characterized by isoosmolarity. Getting into such conditions, sperm simply explodes.
Of course, the amount of saliva and lubricant compared to the amount of sperm is insignificant, but it is important for couples with reduced fertility to remember this.
There is no information about abstinence for natural conception. Analyzing multiple recommendations, we can conclude that the optimal sperm quality is observed on the 2nd-5th day of abstinence. After 24 hours, not enough elements of the seminal fluid are synthesized to protect the genetic material, and after more than 5 days, the phenomena of DNA fragmentation occur, as well as a decrease in the number of motile sperm.
Couples planning a pregnancy should avoid using “mouth moisture” as a lubricant and lubricants from the mass market due to differences in osmolarity and pH, which are detrimental to sperm.
I strongly recommend contacting an andrologist at the stage of pregnancy planning to increase fertility and get recommendations.
💗 to all
Sincerely, your Natalia Silina,
doctor of gynecologist-endocrinologist,
UNICEF and UNFPA expert on sexuality education
My recommendations for proper preparation for pregnancy, you can find in the course: Preparing for pregnancy. I tell more about your partner in the webinar: Health of your beloved man, which is part of the course All about you. How it feels to be a Woman.
You can always find your doctor at the Lior Medical Center.
- Christopher De Jonge, Ph.D.,a Marie LaFromboise “Influence of the abstinence period on human sperm quality”, FERTILITY AND STERILITY 2004
- Eliahu Levitas, M.D. , Eitan Lunenfeld, M.D “Relationship between the duration of sexual abstinence and semen quality: analysis of 9,489 semen samples” , FERTILITY AND STERILITY 2005
- S. Colturato, S. Abdelmassih “Influence of sexual abstinence length on sperm parameters and on IVF outcomes in ICSI assisted treatment cycles”, FERTILITY AND STERILITY 2007
- Pascual Sánchez-Martín, Fernando Sánchez-Martín “Increased pregnancy after reduced male abstinence”. Systems biology in reproductive medicine, May 2013
- Josefina Vargas, M.Sc., Michel Crausaz, M.Sc. “Sperm toxicity of “nonspermicidal” lubricant and ultrasound gels used in reproductive medicine”, FERTILITY AND STERILITY 2004
- Ashok Agarwala, Sajal Gupta “Abstinence Time and Its Impact on Basic and Advanced Semen Parameters” Urology, August 2016