Wednesday, October 17, 2007

Every other day? Maybe not...

In Israel, I sell discount ovulation kits, along with telephone support - so the question as to whether to have sex every day or every-other-day during the fertile time comes up a lot. Being unable to take any sort of responsibility, I quote a doctor (who gave me permission to quote him) and say that if they don't suspect a problem with the quality of the sperm, then every day is fine too. Now it seems that even if there is a problem with the quality of the sperm, sex every day might be better than sex every-other-day.

A pilot study (see article) led by David Greening, of Sydney IVF tested 42 men whose sperm showed significant DNA damage and found that daily ejaculation reduced this damage by 12%. These results were presented at the American Society for Reproductive Medicine conference in Washington yesterday.

Abstaining from sex increases the number of sperm cells that are ejaculated - leading to the recommendation for couples who are trying to conceive to only have sex every two to three days - but the article says that beyond this time period, although the quantity may rise, its quality declines; a trade-off.

I wonder if such DNA damage is tested in a normal sperm analysis, if so, what parameters show it and how common is such damage? If it makes an important difference (knowing whether there is or isn't DNA damage), it seems like information couples should have - and may even make it sensible to have two sperm analyses day-after-day to check if the sperm quality improves.


Bea said...

This is not part of a normal semen analysis and the problem may be present even where the standard semen analysis is normal (and absent even where the standard semen analysis is severely abnormal). Older men (from 35 onwards - sorry guys, the agegrouping isn't much kinder than it is for women, despite popular beliefs) may be more prone than younger men to the problem.

If a sample is abnormal (containing a high index of DNA fragmentation) it is often suggested that the couple try daily ejaculation for a week or more and re-test. Some supplements (co-enzyme Q10, vitamin E, other antioxidants) have been suggested as possibilities for treatment, and testing is underway.

The problem is, even if your sperm's DNA is damaged, how much does it help you to know? It used to be thought that the fragmentation index was fairly constant from month to month, sample to sample, and that anything over 35% was an indication for donor sperm. Now we know that's just not true. Studies have been done showing, for example, that the live, take-home baby rate is the same over a period of two years whether your DNA shows high fragmentation or not.

It's still a grey area. Two things I know for sure - a few months of coQ10 and vitamin E is unlikely to hurt, and if you're using IVF you should definitely ejaculate daily in the leadup, as count is no longer any concern (especially with ICSI).


SaraS-P said...

Arg...sometimes the literature and standard advice just don't synch up.

I just know that the two cycles resulting in pregnancy for me were ones not involving sex everyday. So, I figure any degree of sex around ovulation time must be good enough.

Hmmm...Bea may have a point about IVF, though.