title: Characterizing semen parameters and their association with reactive oxygen species in infertile men.
abstract: BACKGROUND
  A routine semen analysis is a first step in the laboratory evaluation of the infertile male. In addition, other tests such as measurement of reactive oxygen species can provide additional information regarding the etiology of male infertility. The objective of this study was to investigate the association of semen parameters with reactive oxygen species (ROS) in two groups: healthy donors of unproven and proven fertility and infertile men. In addition, we sought to establish an ROS cutoff value in seminal plasma at which a patient may be predicted to be infertile.
  
  
  METHODS
  Seminal ejaculates from 318 infertile patients and 56 donors, including those with proven fertility were examined for semen parameters and ROS levels. Correlations were determined between traditional semen parameters and levels of ROS among the study participants. ROS levels were measured using chemiluminescence assay. Receiver operating characteristic curves were obtained to calculate a cutoff value for these tests.
  
  
  RESULTS
  Proven Donors (n = 28) and Proven Donors within the past 2 years (n = 16) showed significantly better semen parameters than All Patients group (n = 318). Significantly lower ROS levels were seen in the two Proven Donor groups compared with All Patients. The cutoff value of ROS in Proven Donors was determined to be 91.9 RLU/s with a specificity of 68.8% and a sensitivity of 93.8%.
  
  
  CONCLUSIONS
  Infertile men, irrespective of their clinical diagnoses, have reduced semen parameters and elevated ROS levels compared to proven fertile men who have established a pregnancy recently or in the past. Reactive oxygen species are negatively correlated with traditional semen parameters such as concentration, motility and morphology. Measuring ROS levels in the seminal ejaculates provides clinically-relevant information to clinicians.
authors.affiliation: Center for Reproductive Medicine, Cleveland Clinic, Cleveland, Ohio 44106, 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: Reecha
authors.initials: R
authors.lastname: Sharma
authors.forename: Mourad
authors.initials: M
authors.lastname: Assidi
authors.forename: Adel M
authors.initials: AM
authors.lastname: Abuzenadah
authors.forename: Saad
authors.initials: S
authors.lastname: Alshahrani
authors.forename: Damayanthi
authors.initials: D
authors.lastname: Durairajanayagam
authors.forename: Edmund
authors.initials: E
authors.lastname: Sabanegh
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D005298:Fertility; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D009820:Ohio; D010044:Outpatient Clinics, Hospital; D018384:Oxidative Stress; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000378:metabolism*; D012016:Reference Values; D012661:Semen / Q000378:metabolism*; D055101:Semen Analysis; D012680:Sensitivity and Specificity; D014019:Tissue Donors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D017382:Reactive Oxygen Species