Effect of seminal oxidative stress on fertility after vasectomy reversal

Objective: To evaluate seminal oxidative stress in men after vasectomy reve rsal and to determine whether seminal oxidative stress could predict fertil ity after vasectomy reversal. Design: Measurement of seminal reactive oxygen species (ROS) and total anti oxidant capacity (TAC) in normal donors, men who were fertile after vasecto my reversal, and men who were infertile after vasectomy reversal. Setting: A male infertility clinic of a tertiary care center. Patient(s): Thirty men who underwent vasectomy reversal and 17 normal donor s. Intervention(s): None. Main Outcome Measure(s): Semen characteristics, seminal ROS, and TAC were m easured with chemiluminescence assays in samples from donors and reversal p atients. Result(s): Mean adjusted seminal ROS (log [ROS + 1]) was higher in infertil e reversal patients (2.38 +/- 0.25) than in normal donors (1.30 +/- 0.14). Seminal ROS was also higher in all (fertile and infertile reversal combined ) reversal patients than in donors. Total antioxidant capacity did not diff er between groups. The ROS-TAC score, a composite index of seminal oxidativ e stress, was a significant predictor of fertility. A ROS-TAC score of 45 o r greater had a positive predictive value of 73% in predicting fertility. Conclusion(s): Seminal oxidative stress is associated with vasectomy revers al. The ROS-TAC score is a possible predictor of infertility after vasectom y reversal. (Fertil Steril(R) 1999;71:249 -55. (C) 1999 by American Society for Reproductive Medicine.).