Association of sperm DNA fragmentation with abstinence duration, seminal oxidative stress and age: a call to consider abstinence in andrological diagnostics

Introduction According to World Health Organization (WHO) recommendations, the abstinence period for a semen analysis is 2 to 7 days. Other professional medical societies recommend shorter abstinence periods. Since sperm DNA fragmentation (SDF) is positively associated with oxidative stress, age and abstinence, this study aimed at investigating a threshold of abstinence for the diagnostic use of SDF testing. Methods In this retrospective study, SDF (HaloSperm) and oxidative stress (MiOXSYS) were tested in 2782 consecutive patients, attending the Department of Urology at Hamad Medical Corporation in Doha, Qatar. Patients were stratified according to the abstinence. Results Results showed significant trends of higher SDF and oxidative stress with longer periods of abstinence. ROC curve analysis with 20% SDF as classification variable resulted in thresholds of >4 days for abstinence, >37 years for age and 59.9 mV for oxidation-reduction potential. Multiple linear regression analysis revealed abstinence, age and oxidative stress as strong independent predictors of high SDF. Discussion When requesting and interpreting an SDF test, abstinence, age and oxidative stress have to be considered. A maximum of 4 days of abstinence is recommended.