The Effect of Ejaculatory Abstinence Period on Semen Quality among Nigerian Men: A Cross-Sectional Study

Background: One significant pre-analytical factor affecting semen quality and semen analysis interpretation is the length of ejaculatory abstinence. The World Health Organization advises abstinence for two to seven days before semen collection; however, the ideal length of time is still debatable, especially for men whose semen quality is compromised. This study examined the relationship between the length of ejaculatory abstinence and the quality of semen in Nigerian men who were oligozoospermic and normozoospermic and undergoing fertility testing. Methods: A retrospective cross-sectional study was conducted using laboratory semen analysis records of 268 male partners of infertile couples who underwent fertility evaluation between January 2023 and December 2025. Participants were categorized into normozoospermic (≥15 × 10⁶ sperm/mL) and oligozoospermic (<15 × 10⁶ sperm/mL) groups according to WHO 2010 criteria. The period of ejaculatory abstinence was divided into three categories: 2–3 days, 4–7 days, and >7 days. Standardized WHO laboratory protocols were used to analyse semen samples. Semen characteristics were examined between abstinence groups, including volume, sperm count, concentration, motility, morphology, and proportion of dead spermatozoa. To find correlations between age, semen characteristics, and the length of abstinence, correlation analyses were conducted. Statistical significance was set at P < 0.05. Results: Of the 268 participants, 126 (47.0%) were normozoospermic, and 142 (53.0%) were oligozoospermic. The majority of participants (66.8%) stated that they had abstained for four to seven days. Sperm count, sperm concentration, percentage of dead spermatozoa, motility, and morphology all showed significant differences between the two groups (P < 0.05). Abstinence time had a significant impact on sperm count and concentration in oligozoospermic men, while it had a significant impact on sperm count, concentration, semen volume, motility, and morphology in normozoospermic men. In oligozoospermic men, abstinence duration was significantly correlated negatively with both rapid progressive and non-progressive motility, whereas in normozoospermic men, it was positively correlated with semen volume. Conclusion: Although its effects vary depending on baseline semen quality, ejaculatory abstinence length has a considerable impact on conventional semen characteristics. Long-term abstinence seems to negatively impact sperm motility, especially in oligozoospermic males, even if it may increase semen volume and sperm concentration. These results support tailored recommendations on the length of abstinence during assisted reproductive treatment and fertility assessment.