Does the Reduction of Sexual Abstinence Influence Sperm DNA Fragmentation? Exploring the Relationship Between the Two Parameters

Background The exact mechanisms underlying age‐related sperm decline remain unclear. Factors like increased free radicals and prolonged sexual abstinence (SA) have been explored in literature. Recent studies suggest that shorter SA may positively affect sperm parameters, though results are controversial. Objectives This retrospective analysis investigated whether reduced SA provides measurable benefits for sperm DNA fragmentation (SDF) in patients undergoing in vitro fertilization (IVF), across different age groups. Methods 1030 patients underwent both sperm analysis and SDF evaluation. The dataset was both studied entirely and split in groups with generalized linear model (GLM) and quantile regression analyses. Primarily, we considered four groups based on patients’ age (≤38 and >38 years) and days of SA (0–3 and 4–7 days); then, we examined two age‐based groups (≤38 and >38 years). Results SA emerged as a significant predictor of SDF ( p = 0.020), with a stronger effect observed in patients >38 years ( p = 0.013). No significant interaction between age and SA was found in the general model ( p = 0.524), but stratified analysis revealed a threshold effect, where prolonged SA was particularly detrimental in older individuals. Quantile regression further confirmed that SA had the most pronounced impact on patients with higher baseline DNA fragmentation index (DFI), suggesting that oxidative stress accumulates disproportionately in this subgroup. Conclusion Our findings highlight the complex interplay between age, SA, and DFI, demonstrating that prolonged abstinence is especially detrimental for older men. Unlike previous studies, we introduce a threshold effect, emphasizing that the impact of SA is not uniform across all individuals. The use of quantile regression allows a more refined assessment, revealing that those with pre‐existing sperm DNA damage are more susceptible. These results suggest that standard World Health Organization (WHO‐recommended abstinence windows may not be optimal for all patients, particularly in ART settings. However, the clinical significance of these findings requires careful consideration of the trade‐offs between DFI improvement and potential impacts on conventional sperm parameters, advocating for more individualized SA guidelines to improve reproductive outcomes.