Using an in-home semen testing system to evaluate total sperm count and time to conception: a pilot study

Trak provides access in-home semen testing to evaluate total sperm count and time to conception. During this study, in which 36 men participated, 50% of men with <50 million total sperm count conceived. 71.4% of men with a total sperm count >50 million. See Fertility and Sterility for full text.

Objective
To evaluate the association between total sperm count, as measured by an in-home semen testing system, and time to pregnancy (TTP) in a North American preconception cohort study.

Design
Pregnancy Study Online (PRESTO) is a web-based preconception cohort study of North American couples actively trying to conceive1. PRESTO couples who had been attempting conception for fewer than 3 months were invited to participate in a pilot study using the Trak Male Fertility Testing System, a new device for measuring sperm concentration and semen volume at home2. TTP (in cycles) was measured over 12 months via bimonthly female follow-up questionnaires.

Materials and Methods
Participants were mailed a Trak Engine and two test kits at baseline. Users self-reported and uploaded smartphone images of their Trak test results using an online web form. Total sperm count (TSC, million) was calculated as semen volume (ml) x sperm concentration (million/ml). Couples contributed attempt time from study entry until the report of pregnancy or 12 cycles, whichever came first. Discrete-time Cox proportional hazards regression models were used to estimate fecundability odds ratios (FOR) and 95% confidence intervals (CI) for the association between TSC and fecundability.

Result(s)
During 4 months of recruitment, 45 of 82 (55%) men agreed to participate and 36 men (82%) successfully uploaded at least one Trak result. Of the men with a TSC of <50 million, 4/8 (50%) successfully conceived with their female partner during follow-up. Of the men with a TSC of ≥50 million, 20/28 (71.4%) successfully conceived with their female partner during follow-up. Men with a TSC <50 million had 0.72 times the odds of conceiving in any given menstrual cycle relative to men with a TSC ≥50 million, after adjustment for abstinence time (fecundability odds ratio (FOR)=0.72, 95% CI: 0.24-2.13). With further adjustment for male and female age, male and female body mass index (BMI), smoking, and other potential confounders, the FOR was 0.52 (95% CI: 0.11-2.41).

Conclusion(s)
Although imprecise due to the small population of men included in this pilot study, the results suggest an association between an in-home measured low total sperm count and reduced fecundability. Further analysis based on a larger sample of participants is forthcoming.

Authors
Greg J. Sommer, Ph.D., A. Wesselink, T. Trinidad, Ulrich Y. Schaff, Ph.D., Michael L. Eisenberg, M.D., E.E. Hatch, Lauren A. Wise, SCD

September 2017 Volume 108, Issue 3, Supplement, Pages e79-e80