Objectives. Excessive formation of reactive oxygen species (ROS) in hu
man semen has been associated with impaired sperm function and fertili
ty potential. The presence of ROS in semen specimens from normal ferti
le men emphasizes the importance of defining a normal range of RDS for
mation. The purpose of this study was to establish a normal range of R
OS generation and to investigate the effect of sperm concentration on
the ROS level. Methods. ROS was determined in 15 healthy donors and 20
men with suspected infertility. After the sperm concentration in norm
al donors was adjusted to 20 x 10(6)/mL, ROS was measured by chemilumi
nescence using luminol in a Berthold luminometer. A specimen was regar
ded as positive (abnormal) when the value was at least 10 x 10(4) coun
ts per minute (cpm). ROS was also evaluated at 4 sperm concentrations
(60, 30, 15, and 7.5 x 10(6)/mL) from samples obtained from the patien
ts with suspected infertility. In addition, ROS was measured in 7 ROS-
positive specimens at a sperm concentration of 15 x 10(6)/mL and 60 x
10(6)/mL.Results. Results showed that ROS formation was negative in al
l 15 healthy donors (median, 0.9 x 10(4) cpm; interquartile range, 0 t
o 1.48 x 10(4) cpm). The ROS formation value among all the donors was
less than 5.5 x 10(4) cpm. ROS formation was positive in 8 (40%) of th
e suspected infertile patients. ROS levels were significantly lower at
sperm concentrations of 15 x 10(6)/mL or 7.5 x 10(6)/mL compared with
30 x 10(6)/mL or 60 x 10(6)/mL (P = 0.05). The ROS level increased af
ter centrifugation for 10 minutes at 500 g in all 7 specimens at both
15 and 60 x 10(6)/mL. However, the increase in ROS formation at 60 x 1
0(6)/mL was significantly greater than that at 15 x 10(6)/mL (P < 0.00
1). Conclusions. A range of ROS formation of 0 to 5.5 x 10(4) cpm at a
sperm concentration of 20 x 10(6)/mL may be considered as normal for
healthy donor semen. The positive relationship between ROS formation a
nd sperm concentration at the time of measurement emphasizes the impor
tance of concentration adjustment before analysis when comparing ROS l
evels between different specimens.