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Effects of Ejaculation-to-Analysis Delay on Levels of Markers of Epididymal and Accessory Sex Gland Functions and Sperm Motility

JOHAN MALM

From the ^* Reproductive Medicine Center, Scanian Andrology Center, and the Department of Clinical Chemistry, Lund University, Malmö University Hospital, Malmö, Sweden

Correspondence to: Dr Saad Elzanaty, Reproductive Medicine Center, Scanian Andrology Center, Lund University, Malmö University Hospital, SE 205 02 Malmö, Sweden (e-mail: saad.elzanaty{at}med.lu.se).

This study aimed to examine the association between the interval from ejaculation to analysis and epididymal and accessory sex gland function in relation to sperm motility. Ejaculates from 1079 men assessed for infertility were analyzed according to World Health Organization guidelines. Biochemical markers were measured in semen to assess the function of the epididymis (neutral -glucosidase [NAG]), prostate (prostate-specific antigen [PSA] and zinc), and seminal vesicles (fructose). Three groups were defined according to time from ejaculation to analysis: G₃₀ (24–30 minutes), G_31–60 (31–60 minutes), and G_>60 (63–180 minutes). The proportion of progressively motile sperm was significantly lower in G_>60 than in G₃₀ (mean difference, 8.0%; 95% confidence interval [CI], 2.0%–13%) or G_31–60 (mean difference, 6.0%; 95% CI, 1.0%–12%). The proportion of rapid progressive sperm motility was significantly higher in G₃₀ compared with G_31–60 (mean difference, 3.0%; 95% CI, 1.0%–5.0%) and G_>60 (mean difference, 6.0%; 95% CI, 1.0%–10%). Sperm morphology and viability did not vary significantly between the groups. However, PSA levels in G_>60 were 29% and 31% significantly lower than in G₃₀ (95% CI, 3.0%–54%) and G_31–60 (95% CI, 7.0%–58%), respectively. Moreover, men in G_>60 had 29% and 17% significantly lower zinc compared with those in G₃₀ (95% CI, 4.0%–69%) and G_31–60 (95% CI, 4.0%–64%), respectively. Levels of NAG and fructose did not differ significantly between the groups. There were negative associations between the ejaculation-to-analysis interval and sperm motility and levels of PSA and zinc. In male infertility assessments, semen analysis should be performed within 60 minutes of ejaculation.

     Key words: Biochemical markers, morphology, semen analysis, viability