title: Reactive oxygen species as an independent marker of male factor infertility.
abstract: OBJECTIVE
  To determine the abnormal patterns of reactive oxygen species (ROS) production in male factor infertility (MFI) patients and to define the ROS reference values in such patients.
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  Male infertility clinic at a tertiary healthcare center.
  
  
  METHODS
  We examined 132 MFI patients (all normal sperm parameters, n = 24, and all abnormal sperm parameters, n = 38) and 34 healthy donors.
  
  
  METHODS
  Routine semen analysis, measurement of ROS.
  
  
  METHODS
  Sperm parameters, ROS levels (10(4) cpm/20 x 10(6) sperm).
  
  
  RESULTS
  Normal, healthy donors had significantly higher (P<.0001) sperm concentration, motility, and morphology compared with all MFI patients. Univariate analysis indicated a significant association between MFI and log (ROS + 1) (odds ratio [OR] = 3.84), besides sperm parameters and age. A multivariate model using logistic regression analysis also indicated an independent association of log ROS with MFI (OR = 4.25). The ROS cutoff values of 1.2-1.4 had a sensitivity of 0.70-0.78 with a corresponding specificity of 0.82. However, at a cutoff point of 1.2, the OR was 68.6, which increased with an increase in the cutoff.
  
  
  CONCLUSIONS
  High ROS is an independent marker of MFI, irrespective of whether these patients have normal or abnormal semen parameters. We suggest the inclusion of ROS measurement as part of idiopathic infertility evaluation. Treatment with antioxidants may be beneficial in such patients.
authors.affiliation: Center for Advanced Research in Human Reproduction, Infertility and Sexual Function, Glickman Urological Institute and Department of Obstetrics-Gynecology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. agarwaa@ccf.org
authors.forename: Ashok
authors.initials: A
authors.lastname: Agarwal
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Sharma
authors.forename: Kiran P
authors.initials: KP
authors.lastname: Nallella
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Thomas
authors.forename: Juan G
authors.initials: JG
authors.lastname: Alvarez
authors.forename: Suresh C
authors.initials: SC
authors.lastname: Sikka
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D017382:Reactive Oxygen Species / Q000032:analysis*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012661:Semen / Q000378:metabolism*; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D017382:Reactive Oxygen Species