Iranian Journal of Reproductive Medicine Vol. 2. No.1 pp9-11, 2004

Comparison between Semen Parameters of Ejaculates Collected
Via Masturbation Versus Coitus Interruptus
Valli A. Dehghani M.D.1, Mohammad A. Khalili Ph.D.1, Nahid Zamani M.D.2, Fakhri Dreh-Zereshki M.D.2
1
2

Research and Clinical Center for Infertility, Yazd, Iran.
School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Proper collections of human ejaculates are necessary for semen analysis and infertility
treatment purposes. The objective of this study was to assess the seminal characteristics ofejaculates collected by patients via masturbation and coitus interruptus. Thirty individuals
produced one sample via masturbation and one via incomplete coitus during a 3-days interval.
The semen parameters were compared and analyzed with student t-test and Nemar test. The
results showed that mean values for progressive motility of spermatozoa were increased from46.81+15.7% to 58.76+13.5% in coitus interruptus and masturbation, respectively (P<0.01).
Also, the mean values for normal sperm morphology was 54.03+25.1% in coitus interruptus
and 63.36+13.4% in samples collected via masturbation (P<0.01). In addition, sperm
concentration was significantly improved in ejaculates collected with masturbation (P<0.05).
Although, insignificant, the concentration of round cells were lower in specimens collected
via masturbation than coitus interruptus. Therefore, via masturbation method, better semen
characteristics were yielded which subsequently may improve the infertility treatment
outcome.
Key Words: Semen Analysis, Masturbation, Coitus Interruptus

Introduction
the acid PH of the vagina adversely affects the spermquality. However, many patients prefer incomplete
coitus as means of sperm collection in Islamic
societies. Therefore, the objective of thisinvestigation was to compare the semen
characteristics in ejaculates of Iranian patients bymeans of masturbation and coitus interruptus by a 3days interval.

Normal semen is a mixture of motile and nonmotile spermatozoa and viscous fluid. Therefore,
proper collections and analysis of ejaculates must be
undertaken by standard procedures in order toprovide the valid information on the reproductive
status of the individuals (Zavos 1986). In addition,with the advent of assisted reproductive techniques(ART), the standard collection of ejaculates alongwith manipulative techniques become more crucial
for harvesting the maximum quality and quantity ofspermatozoa for successful infertility treatment
program (Lambard et al., 2004).
Various methods for semen collection havebeen employed for semen analysis or for ART
program. These methods include masturbation,
incomplete intercourse (coitus interruptus), andcomplete intercourse. WHO (1999) recommends
collection of ejaculates via masturbation, and notwith coitus interruptus. This is because the firstportion of ejaculate, which contains the highest
concentration of sperm may be lost at intercourse.
Moreover, bacterial contamination of the sample andMaterials and Methods
Thirty men who were referred to the research andclinical center for infertility laboratory for
andrological evaluation participated in this study.
They were instructed to produce one semen specimen
via masturbation and another one via incomplete
intercourse by 3 days intervals. Each specimen wascollected into a sterile, wide-mouthed container.
Semen specimens were assessed according to theWHO standards for volume, viscosity, sperm
concentration, progressive and non- progressive
motility, normal morphology, and concentration of
non-spermatozoal round cells. The semen samples
used in this study were considered normozoospermic
according to WHO guidelines (1999). Statisticalanalysis was performed using the student t-test andCorresponding Author:
Dr. Mohammad A. Khalili. Research and Clinical Center
for Infertility, Yazd University of Medical Sciences, Yazd,Iran.
E-Mail: khalili59@hotmail.com

9Iranian Journal of Reproductive Medicine Vol. 2. No.1 pp9-11, 2004

Table I. Comparison of Semen Analysis for Ejaculates Collected Via Masturbation and Coitus Intrruptus.
Semen Parameters

Coitus Intrruptus

Masturbation

P

Normal viscosity (%)

86.7

83.3

>0.05

3.45±1.8 (0.5-8.5)

3.96±1.4 (0.5-6.3)>0.05

Concentration (x10 /ml)

87.03±49.9 (3-160)

110.33±54.1 (10-180)<0.05

Progressive motility (%)

46.81±15.7 (0-75)

58.76±13.5 (10-70)<0.01Volume (ml)6

Non-progressive motility (%)

7.63±4.5 (0-17)8.70±3.9 (0-15)>0.05

Normal morphology (%)

54.03±25.1 (2-75)

63.36±13.4 (18-75)<0.01

Round cells (x106/ml)

3.33±3.3 (0-8)

2.93±2.3 (0-8)>0.05

Values are Means±SD (range)

the vital semen parameters which alternatively may
result in reduction of fertilization and pregnancy
rates.
Another important finding in our study was thefact that four cases were considered as severe
oligozoospermia when ejaculates were collected withMC Nemar test. Differences were considered
statistically significant when P<0.05.

Results
The results obtained from this study are reportedin Table I. The sperm concentration from specimenscollected via masturbation was significantly higher
than coitus intrruptus ejaculates. Also, bothprogressive motility and normal morphology of
spermatozoa recovered via masturbation werequalitatively superior (P<0.01), compared with theejaculates collected via interrupted intercourse.
Furthermore, four samples were reported as severe
oligospermia in coitus intrruptus group (2.5x106),
which were improved to 11.2x106 when specimens
were collected via masturbation.

incomplete coitus. The samples were improved to anormal oligozoospermia when collections were donevia masturbation. However, it should be emphasizedthat some patients in Iran due to psychological status
or religious belief refuse to collect ejaculates via
masturbation. For these subjects, Zarmakoupis andcolleagues (1999) recommended to use a semencollection device at intercourse. These types ofdevices consist of a nonspermicidal condom thatallows the patients to collect the ejaculates via thecomplete intercourse. The collected semen, as theyassessed, contains high concentration of spermatozoa
that have greater motility when compared withsamples obtained via the coitus intrruptus method.
(Zavos et al., 1994).
In conclusion, the generated results indicate thatsemen collection via coitus intrruptus is notrecommended in infertility treatment programs. The
method of choice for collection of high quality
spermatozoa with low concentration of round cells is
via masturbation. However, if patients refuse toemploy the masturbation method, the ejaculates
should be produced via the use of nonspermicidal
condoms at intercourse.

Discussion
The most widely accepted method of semencollection for the purpose of semen analysis or ART
is by means of masturbation (Sofikitis and Miyagawa
1993; WHO, 1999; Zavos 1986). The results fromthis study showed that collection of ejaculates via
masturbation is more superior to coitus intrruptus.
Collection of semen by means of masturbation
resulted in reduction of non-spermatazoal round cellconcentration, while the qualitative characteristics
such as sperm concentration, progressive motility,and normal morphology were significantly enhanced
when compared with results from incomplete coitus.
The largest contributors to the round cell population
are the immature germ cells followed by leukocytes
which may indicate the presence of genital tract
infections (Smith et al., 1989).
With ART advancements, the desire for using
higher quality spermatozoa to achieve higher successrates has significantly increased (Lambard et al.,2004). Therefore, it seems that semen collection via
coitus intrruptus should not be practiced for clinicalpurposes. The results clearly demonstrated that theaforementioned method of semen collection will alter

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Iranian Journal of Reproductive Medicine Vol. 2. No.1 pp9-11, 2004

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