Creatine kinase as an indicator of sperm quality and maturity in men with oligospermia

Objectives. To determine the differences among the creatine kinase (CK) lev els in the spermatozoa of subfertile men with mild, moderate, or severe oli gospermia and to examine the differences in CK activity between infertile p atients with various clinical diagnoses and a group of normal healthy donor s (control). CK is a marker of sperm maturity that correlates with the sper m fertilizing capacity. Elevated levels are associated with an increased ra te of functional abnormalities and increased cytoplasmic retention. Methods. We compared the CK levels in 51 oligospermic men who could not ini tiate a pregnancy. Patients were categorized according to their degree of o ligospermia as defined by the total sperm count: mild (greater than 10 to 4 0 x 10(6); n = 30), moderate (5 to 10 x 10(6); n = 11), and severe (less th an 5 x 10(6); n = 10). These patients were further classified according to their diagnosis (ie, varicocele, n = 24; unexplained infertility, n = 17; v asectomy reversal, n = 9; and unknown diagnosis, n = 1). A separate group c onsisting of 25 healthy donors was included as a control group. A computer- assisted semen analyzer assessed the sperm characteristics, and the CK leve ls were measured using a CK test kit after the enzyme was extracted with Tr iton-X. Results. The CK levels were significantly higher in the sperm of the severe ly oligospermic group (8.8 +/- 6.5 IU/10(8) sperm) than in the moderate (0. 50 +/- 0.19 IU-10(8) sperm) and mild (0.49 +/- 0.15 IU/10(8) sperm) groups (P <0.0001). The mean CK level in the severely oligospermic group was 18-fo ld higher than that in the moderate (P = 0.03) and mild (P <0.001) groups. The CK levels were significantly higher in all three infertile groups compa red with the donor group (0.06 +/- 0.01 IU/10(8) sperm). Patients with vari cocele had the highest CK level (3.42 +/- 2.56 IU/10(8) sperm) compared wit h patients in the vasectomy reversal group (1.73 +/- 0.98 IU/10(8) sperm) a nd the idiopathic infertility group (0.26 +/- 0.08 IU/10(8) sperm). Conclusions. Elevated CK levels are associated with severe oligospermia, ir respective of the clinical diagnosis. CK may be a sensitive indicator of sp erm quality and maturity in the follow-up of patients treated for male fact or infertility. UROLOGY 58: 446-451, 2001. (C) 2001, Elsevier Science Inc.