Physiologic and pathologic levels of reactive oxygen species in neat semen of infertile men

Objective: To define physiologic levels of reactive oxygen species in infertile men and establish a cutoff value of reactive oxygen species level in neat semen with a high sensitivity and specificity to differentiate infertile men from fertile donors (controls). Design: Reactive oxygen species levels were measured in the neat semen samples (n = 51) from fertile donors and infertile patients (n = 54). Setting: Reproductive research laboratory at a tertiary care hospital. Patient(s): Infertile patients from male infertility clinic. Intervention(s): Reactive oxygen species measurement in neat semen sample using luminol-based chemiluminescence method, receiver operating characteristic curves. Main Outcome Measure(s): Seminal reactive oxygen species levels, cutoff value, sensitivity and specificity, positive and negative predictive values. Result(s): The best cutoff value to distinguish between healthy fertile donors and infertile men was 0.0185 x 10(6) counted photons per minute/20 x 10(6) sperm. At this threshold, the specificity was 82% and the sensitivity was 78%. This value can be defined as basal reactive oxygen species level in infertile men. Conclusion(s): Reactive oxygen species levels in neat semen samples as measured by luminol-based chemiluminescence are a highly specific and sensitive test in the diagnosis of infertility. This test also may help clinicians treat patients with seminal oxidative stress. (Fertil Steril (R) 2009;92:1626-31. (C) 2009 by American Society for Reproductive Medicine.)