Objective

During the COVID-19 era, semen collection at infertility centers might increase the risk of spreading SARS-CoV-2. Seminal fluid collection at home is an alternative method for preventing this spread. However, there is no conclusion about the effect of home vs clinic semen collection on semen parameters and assisted reproductive technology outcomes. This systematic review and metaanalysis aimed to assess the effect of semen collection location on semen parameters and fertility outcomes.

Data Sources

A literature search was conducted using the major electronic databases including MEDLINE via Ovid, EMBASE, Scopus, CINAHL, OpenGrey, and CENTRAL from their inception to September 2021. ClinicalTrials.gov was searched to identify the ongoing registered clinical trials.

Study Eligibility Criteria

We included all human randomized controlled trials and observational studies that investigated the effect of at-home semen collection vs in-clinic semen collection on semen parameters and fertility outcomes.

Methods

We pooled the mean difference and risk ratio using Review Manager software version 5.4.1 (The Cochrane Collaboration, 2022). The Grading of Recommendations, Assessment, Development and Evaluations approach was applied to assess the quality of evidence.

Results

Seven studies (3018 semen samples) were included. Overall, at-home semen collection results made little to no difference in semen volume (mean difference, 0.37; 95% confidence interval, −0.10 to 0.85; low-quality evidence), sperm count (mean difference, −6.02; 95% confidence interval, −27.26 to 15.22; very low-quality evidence), and sperm motility (mean difference, 0.76; 95% confidence interval, −4.39 to 5.92; very low-quality evidence) compared with in-clinic semen collection. There was no difference in fertilization rate (risk ratio, 1.00; 95% confidence interval, 0.97–1.03; very low-quality evidence) and pregnancy rate in in vitro fertilization (risk ratio, 1.04; 95% confidence interval, 0.86–1.25; very low-quality evidence).

Conclusion

At-home semen collection had no adverse effects on semen parameters or fertility outcomes compared with in-clinic collection. However, higher-quality evidence is needed.

中文翻译：

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精液采集地点对精液参数和生育结果的影响以及对 COVID-19 时代实践的影响：随机和观察性研究的系统回顾和荟萃分析

客观的

在 COVID-19 时代，不育中心的精液采集可能会增加传播 SARS-CoV-2 的风险。在家收集精液是防止这种传播的另一种方法。然而，关于家庭精液采集与诊所精液采集对精液参数和辅助生殖技术结果的影响尚无定论。本系统回顾和荟萃分析旨在评估精液采集地点对精液参数和生育结果的影响。

数据源

从成立到 2021 年 9 月，使用主要电子数据库（包括 MEDLINE via Ovid、EMBASE、Scopus、CINAHL、OpenGrey 和 CENTRAL）进行了文献检索。检索了ClinicalTrials.gov 以确定正在进行的注册临床试验。

学习资格标准

我们纳入了所有人类随机对照试验和观察性研究，这些研究调查了家庭精液采集与诊所精液采集对精液参数和生育结果的影响。

方法

我们使用 Review Manager 软件版本 5.4.1（The Cochrane Collaboration，2022）汇集了平均差和风险比。建议分级、评估、制定和评估方法用于评估证据质量。

结果

包括七项研究（3018 个精液样本）。总体而言，家庭精液采集结果对精液量（平均差异为 0.37；95% 置信区间为 -0.10 至 0.85；低质量证据）、精子数量（平均差异为 -6.02；95% 置信度）几乎没有影响间隔，-27.26 到 15.22；非常低质量的证据）和精子活力（平均差，0.76；95% 置信区间，-4.39 到 5.92；非常低质量的证据）与临床精液采集相比。受精率（风险比 1.00；95% 置信区间 0.97-1.03；极低质量证据）和体外受精妊娠率（风险比 1.04；95% 置信区间 0.86-1.25；极低质量证据）没有差异。非常低质量的证据）。

结论

与诊所采集相比，在家采集精液对精液参数或生育结果没有不利影响。然而，需要更高质量的证据。