Is age a critical indicator for determining the optimal abstinence duration in patients undergoing sperm acquisition?

INTRODUCTION: Sperm cryopreservation is increasingly recognized as a key strategy for fertility preservation, particularly for male infertility patients who may benefit from assisted reproductive technology (ART). However, the optimal abstinence period for maximizing semen quality prior to cryopreservation remains unclear, and whether this optimum varies with patient age has not been systematically investigated. METHODS: We retrospectively analyzed semen parameters from male patients who underwent sperm cryopreservation for fertility preservation at Guangdong Provincial Reproductive Hospital. Patients were stratified by age (<40 years vs. ≥40 years). Semen samples were collected after different abstinence durations (0-2, 3-5, 6-7 and ≥7 days). Sperm quality indicators-including volume, concentration, motility, and progressive motility-were compared across abstinence groups within each age stratum. RESULTS: Results showed that among patients aged over 40 years, sperm quality was optimal after 0-2 days of abstinence despite reductions in semen volume and concentration. By contrast, in younger patients (under 40 years), the highest semen quality was observed following 3-5 days of abstinence. Additionally, prolonged abstinence periods were linked to unstable semen quality in the older patient group, making them less ideal candidates for sperm cryopreservation. DISCUSSION: This study is the first to demonstrate that the relationship between abstinence duration and sperm quality is strongly modified by patient age. Our findings indicate that older patients achieve better and more consistent outcomes with shorter abstinence. The findings offer new perspectives for guiding sperm cryopreservation and determining the optimal timing for sperm retrieval in patients of different age groups to improve sperm quality and increase success rates in assisted reproductive outcomes.