A prospective study of semen quality and fecundability among North American couples planning pregnancy

Sharonda M. Lovett; Greg J. Sommer; Dmitrii Krivorotko; Amelia K. Wesselink; Kenneth J. Rothman; Elizabeth E. Hatch; Michael L. Eisenberg; Lauren A. Wise

doi:10.1111/andr.70084

July 11, 2025AndrologyOpen Access

A prospective study of semen quality and fecundability among North American couples planning pregnancy

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Key Points

To prospectively investigate the association between semen quality parameters, classified by 2021 World Health Organization thresholds, and couple fecundability.
Analyzed prospective data from N=763 male participants aged ≥21 years and their female partners aged 21-45 attempting conception for ≤6 cycles in the North American PRESTO study (2015-2024).
Assessed 1,376 at-home semen samples for volume, sperm concentration, and motile sperm concentration, defining low quality via 2021 WHO thresholds.
Followed female pregnancy status bimonthly for up to 12 cycles and estimated fecundability ratios (FRs) using proportional probabilities regression models adjusted for confounders.
After accounting for censoring via life-table methods, 80.7% of couples conceived within 12 cycles.
Low sperm concentration (≤16 million/mL) and low total sperm count (≤39 million) were associated with reduced fecundability, with FRs of 0.74 (95% CI, 0.56-0.97) and 0.58 (95% CI, 0.38-0.88), respectively.
Fecundability ratios were 1.48 (95% CI, 1.05-2.08) for low semen volume (≤1.5 mL), 0.98 (95% CI, 0.81-1.19) for low motility (≤42%), and 0.73 (95% CI, 0.52-1.04) for low total motile count (≤21 million).

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Implication

Prospective cohort study observes reduced fecundability with suboptimal semen parameters in pregnancy-planning couples, indicating the relevance of updated sperm thresholds.

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Cite This Study

Lovett et al. (2025) studied this question.

synapsesocial.com/papers/6a11e975b08ebdaba18e0eb4 https://doi.org/10.1111/andr.70084

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A prospective study of semen quality and fecundability among North American couples planning pregnancy

Key Points

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Implication

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Cite This Study

A prospective study of semen quality and fecundability among North American couples planning pregnancy

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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