Second ejculation is better for IVF outcomes?!

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https://www.instagram.com/reel/Dcq2hqEIArA/?igsi=eXNxZmU4eTQxbmJ1

I saw this video on Instagram, apparently research strongly suggests a second ejaculation 1 to 3 hours after the first has less DNA fragmentation and can improve outcomes. I decided to Google it, and shockingly, it's true!

I also looked into the risk of zero sperm in the second sample if some men already have low sperm as a baseline (like my husband, who has 5 million per ml). Apparently, research suggests even then the sperm outcomes are favorable (see screenshot).

This factor seems so critical to fertilisation and embryo quality, I'm baffled as to why this hasn't already prompted a comprehensive system review!

Has anyone else come across this?

Bump

I think guidance on this varies a lot between clinics - my clinic advised us (history of slightly low morphology but no other MFI) that the guidance to abstain for a few days beforehand was outdated as its better for the sperm to be fresher but didn't advise as short as that. So we had a gap of slightly over 24h. We got good numbers - who knows if they would have been better or worse with a shorter or longer gap but we were definitely happy with our results.

The research into this is fairly preliminary, it looks promising but it isn't super well studied (the trials aren't that big or comprehensive, for example), and research takes time to filter into clinical practice. It's also the question - 1-3 hours later compared to what? If patients in the control group vary from 1 day earlier to 7 days earlier, it's not really a meaningful comparison.

This research has only been done in the context of ICSI, and a lot of IVF in the UK is conventional IVF (where total sperm count is much more important) rather than ICSI.

There's also the aspect that some men may find it difficult to finish again after a shorter gap. So then there are logistics/resource questions - do they provide both samples in clinic in case the second one isn't possible? (More work for the teams processing them, more space required at the clinics). Do they do one at home the morning before attending the clinic? (Risk of the second one not being possible). Obviously none of these are insurmountable problems, but they are things that need to be considered.

There is so much we still don't know about optimising IVF. Sperm counts and performance is one of the easiest parts to study, so I really hope research in this area carries on