The rationale for requesting a second consecutive sperm ejaculate for assisted reproductive technology

We assessed the value of requesting a second semen sample provided within 1 hour of the first in cases of unacceptable ejaculate quality (compared to previous occasions) or very poor semen characteristics. The study populatio n consisted of 109 males with severe oligoterato-astenospermic (OTA) syndro me in an assisted reproduction program. Semen volume, sperm count and sperm motility were recorded in the first and second samples with a Makler Count ing Chamber before sperm processing, and total motile sperm in the ejaculat e was calculated. Differences in sperm parameters between the consecutive s ampler were determined by paired-sample t test. In 36 cases (33%) the secon d sample was found to be superior in quality to the first and was therefore used for the fertilization process. Of the 12/109 cases in which the first ejaculate demonstrated no motile sperm, five (41%) had detectable motile s perm in the second (total 0.1 x 10(6), 0.2 x 10(6), 0.3 x 10(6), 8.4 x 10(6 ) and 20.8 x 10(6)). We conclude that a request for second ejaculate immedi ately after the first in males with poor semen quality or no detectable mot ile sperm can yield a better sample in a significant percentage of carer. U sing this method, clinicians can avoid the utilization of elaborate sperm p rocessing techniques and the need for unnecessary micromanipulative fertili zation.