SPERM SEPARATION IN PATIENTS WITH UROGENITAL INFECTIONS

A total of 196 patients attending the Center of Dermatology and Androl ogy, Giessen, Germany, were examined for fertility problems. Polymorph onuclear elastase, reactive oxygen species (ROS) and the number of rou nd and peroxidase-positive cells were investigated in addition to rout ine semen analysis. The ejaculates were also analysed before and after sperm separation by means of swim-up or glass wool filtration. In 20 cases of leukocytospermia, sperm concentration, motility, viability, p roduction of reactive oxygen species, and the number of peroxidase-pos itive cells were evaluated before and after glass wool filtration. The results show that ROS production by viable spermatozoa is highly corr elated with the concentration of PMN elastase and the number of both p eroxidase-positive and round cells. Multiple regression analysis with motility as dependent parameter showed the number of round cells (n=91 ; r=-0.332; P=0.0030) to be the most important parameter affecting mot ility, while ROS mainly affects the viability of spermatozoa (n=69; r= 0.250; P=0.0107). In the case of leukocytospermia, glass wool filtrati on significantly reduced the number of peroxidase-positive cells and R OS production (P=0.0098 and P=0.0005, respectively). Receiver operatin g characteristic (ROC) curve analysis for ROS production in the ejacul ate using a concentration of 1.000 ng ml(-1) PMN elastase as decisive parameter resulted in a cut-off value of 49,489.9 counts 10(-7) viable spermatozoa. The statistical parameters were: Sensitivity: 63.2%, spe cificity: 100%, positive predictive value: 100%, negative predictive v alue: 36.1%.