Relationship between oxidative stress, semen characteristics, and clinicaldiagnosis in men undergoing infertility investigation

Objective: To determine whether particular semen characteristics in various clinical diagnoses of infertility are associated with high oxidative stres s and whether any group of infertile men is more likely to have high semina l oxidative stress. Reactive oxygen species (ROS) play an important role in sperm physiological functions, but elevated levels of ROS or oxidative str ess are related to male infertility. Design: Measurement of sperm concentration, motility, morphology, seminal R OS, and total antioxidant capacity (TAC) in patients seeking infertility tr eatment and controls. Setting: Male infertility clinic of a tertiary care center. Patient(s): One hundred sixty-seven infertile patients and 19 controls. Intervention(s): None. Main Outcome Measure(s): Semen characteristics, seminal ROS, and TAC in sam ples from patients with various clinical diagnoses and controls. Result(s): Fifteen patients (9.0%) were Endtz positive and 152 (91.0%) Endt z negative. Sperm concentration, motility, and morphology were significantl y reduced in all groups compared with the controls (P = .02), except in var icocele associated with infection group. Mean (SD) ROS levels in patient gr oups ranged from 2.2 +/- 0.13 to 3.2 +/- 0.35, significantly higher than co ntrols (1.3 +/- 0.3; P<.005). Patient groups had a significantly lower mean (+/-SD) TAC from 1014.75 +/- 79.22 to 1173.05 +/- 58.07 than controls (165 3 +/- 115.28, P<.001), except in the vasectomy reversal group (1532.02 +/- 74.24). Sperm concentration was negatively correlated with ROS both overall and within all groups (P less than or equal to.007), with the exception of idiopathic infertility. Conclusion(s): Irrespective of the clinical diagnosis and semen characteris tics, the presence of seminal oxidative stress in infertile men suggests it s role in the pathophysiology of infertility. Medical or surgical treatment s for infertility in these men should include strategies to reduce oxidativ e stress. (C) 2000 by American Society for Reproductive Medicine.