Objective: To compare the bacteriologic quality of samples after direct verbal or written counseling for semen collection. Design: Prospective randomized comparative study. Setting: Laboratories of biology of reproduction and microbiology in university hospitals. Patients: Male partners of infertile couples on their first attempt to collect semen were assigned randomly into two groups. Intervention: In one group (n = 52) the patients were given direct verbal instruction by one of the investigators on how to avoid bacterial contamination during semen collection. In the other group (n = 52) the patients were asked to follow the usual written instructions. Main Outcome Measure: Bacterial count, number of species, classification of the samples in positive, negative, and noninformative cultures. Results: Direct verbal teaching significantly reduced the bacterial count (2.06 +/- 1.6 versus 3.29 +/- 1.6 log cfu/mL; mean +/- SD) and number of species (1.44 +/- 2.02 versus 3.25 +/- 2.25), increased the percentage of sterile cultures (59.6% versus 23.1%), and decreased the percentage of noninformative cultures (29.9% versus 50%). Conclusion: Direct verbal counseling on how to avoid bacterial contamination during semen collection significantly improves the bacteriologic quality of the samples.
