Home Semen Collection Feasible for Assisted Reproduction
Key findings
- This study compared 119 assisted reproduction cycles in which men collected semen samples at the Massachusetts General Hospital Fertility Center with 125 cycles in which samples were collected at home after the COVID-19 shutdown
- Compared with clinic collection, home collection had no significant effect on sperm parameters (motility, total motile count and forward progression score 0–4), fertilization rate, day 5 usable quality blastocyst development rate or pregnancy rate
- The average time to processing was significantly longer after home collection than clinic collection (83 minutes vs. 36 minutes; P<0.001)
- These findings suggest couples can routinely choose to collect semen samples at home as long as they live within two hours of the fertility clinic and the male partner can deliver the sample himself to ensure proper identification
Because of the COVID-19 pandemic and Massachusetts policies for elective procedures, the Fertility Center at Massachusetts General Hospital shut down between March 24 and June 5, 2020. Upon re-opening the only protocol change was to allow home semen collection.
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Caitlin R. Sacha, MD, Vincent fellow in Reproductive Endocrinology and Infertility, Charles L. Bormann, PhD, director of the Vincent Embryology Laboratory, and colleagues at the Fertility Center retrospectively examined how the change in semen collection location and time to processing affected sperm parameters and early outcomes of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Their reassuring report appears in the Journal of Assisted Reproduction and Genetics.
Study Methods
Couples were included if oocytes were retrieved for IVF/ICSI between January 1 and July 31, 2020. The study compared 119 cycles in which male partners collected semen samples at the clinic and 125 cycles in which samples were collected at home or otherwise offsite after the COVID-19 shutdown.
At the clinic, collection occurred in a room adjacent to the andrology laboratory, and samples were processed within about 30 minutes. Men who collected a sample at home were asked to keep it at body temperature and bring it to the clinic within two hours with a valid form of identification.
Semen samples collected at home were processed within 20 minutes of receipt. If they could not be processed immediately, they were held at 37°C.
Collection Location
Compared to cycles with clinic collection, home collection had no significant effect on:
- Sperm parameters (motility, total motile count and forward progression score 0–4)
- Fertilization rate per cycle
- Day 5 usable quality blastocyst development rate (D5-UQBR) per cycle
- Pregnancy rate per fresh transfer cycle
Time to Processing
- The average time to processing was significantly longer after home collection than clinic collection (83 vs. 36 minutes; P<0.001)
- Increased time to semen processing had no effect on sperm motility, total motile count, fertilization rate, D5-UQBR or pregnancy rate
- This was true even after adjustment for maternal age, paternal age, days of abstinence from ejaculation and fertilization method (IVF or ICSI)
- Increased time to processing was linked to an overall increase of 0.002 in forward progression score; although statistically significant (P=0.04), the increase is unlikely to be clinically meaningful
Commentary
These findings suggest couples undergoing IVF/ICSI can routinely choose to collect semen samples at home as long as they live within two hours of a fertility clinic and the male partner can deliver the sample himself to ensure proper identification.
Only 7% of cycles studied were for conventional IVF, which may be more susceptible than ICSI to deterioration in sperm motility or quality. Investigation of a larger IVF cohort is warranted.
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