Relationship between semen quality and the seminal plasma components carnitine, alpha-glucosidase, fructose, citrate and granulocyte elastase in infertile men compared with a normal population

The seminal plasma components neutral a-glucosidase, carnitine, fructose, c itrate, and polymorphonuclear granulocyte (PMN) elastase in 253 men were de termined. The seminal plasma of 221 infertile men, a control group with pro ved fertility and 13 patients after vasectomy were investigated. The concen trations of free carnitine (212 versus 521 mu mol/l, n = 219, P < 0.001), t otal carnitine (437 versus 743 mu mol/l, vt = 219, P < 0.001), and the acti vity of neutral alpha-glucosidase (15.1 versus 23.4 IU/l, n = 236, P < 0.05 ) were significantly reduced in the infertile patient group as compared to the fertile control group, the concentration of PMN elastase (102 versus 48 mu g/l, n = 234, P < 0.05) being significantly increased in the infertile patients. In the patients after vasectomy the activity of neutral alpha-glu cosidase was the only epididymal marker that was significantly reduced (4.3 versus 9.8 IU/l, n = 35, P = 0.002) in comparison with the patients with t esticular azoospermia, At a limit of 6 IU/l the sensitivity of the method t vas 92% anal the specificity was 72%. Altogether, the epididymal markers we re reduced in subfertile patients compared with the control group. For the differential diagnosis of azoospermia only the determination of the neutral a-glucosidase activity is useful.