Interaction effects of age and abstinence duration on semen quality

Guowei Du^1,#, Jianhuai Chen^2,#, Heng Wang³, Shanshan Chen¹, Yanting Wang¹, Jing Wang¹, Guangzhao Yang⁴, Siwen Liu^5,*, Xuanyi Chen^1,*
1 Department of Reproduction, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
2 Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
3 Department of Urology, Suzhou Hospital, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Suzhou, China
4 Department of Andrology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
5 Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
* Corresponding Author: Siwen Liu. Email: email ; Xuanyi Chen. Email: email
# Guowei Du and Jianhuai Chen are co-first authors
(This article belongs to the Special Issue: Health Determinants of Male Fertility)

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.079848

Received 29 January 2026; Accepted 02 June 2026; Published online 15 July 2026

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Abstract

Objective: Given that the interactive effects of age and abstinence duration on semen quality remain unclear and current guidelines lack age-specific recommendations, this study aimed to evaluate the independent and interactive effects of these factors on semen parameters and to identify the optimal abstinence period for semen analysis across different age groups. Methods: A retrospective analysis was conducted on 1480 men who underwent semen analysis according to the WHO 5th edition guidelines. Participants were stratified by age (20–34 vs. 35–58 years) and abstinence duration (1–3, 4–6, and 7–11 days). A comprehensive set of semen parameters was analyzed, and statistically significant indicators were reported, including semen volume, sperm concentration, total sperm number, motility-related parameters, morphological indices, and functional indices. Statistical analyses included Mann–Whitney U, Kruskal–Wallis, Spearman correlation, Scheirer–Ray–Hare two-way nonparametric ANOVA, and simple effect analysis. Results: Only 23.04% had normal semen quality; asthenozoospermia (52.77%) and teratozoospermia (56.35%) were most common. Older age was associated with lower semen volume, total sperm count, and progressive motility, and higher immotile sperm percentage, TZI, and SDI (all p < 0.05). Longer abstinence increased sperm count and concentration but decreased progressive motility (p = 0.001) and increased SDI (p = 0.017). No significant Age × Abstinence interactions were found for any parameter (all p > 0.05); both factors exerted independent main effects. Age-stratified descriptive data showed that 4–6 days of abstinence optimized sperm quantity while preserving motility in both age groups. Conclusions: Age and abstinence duration independently influence semen quality without significant interaction. We recommend a uniform abstinence period of 4–6 days for semen analysis in Chinese men, balancing sperm quantity and quality across age groups without need for age-specific adjustments.