Clinical utility of reactive oxygen species as a diagnostic test in the evaluation of male infertility

Abstract

OBJECTIVE: To establish the clinical utility of offering ROS as a diagnostic marker of oxidative stress in a clinical setting.DESIGN: ROS measurement in seminal ejaculates by chemiluminescence.MATERIALS AND METHODS: Levels of ROS were measured by chemiluminescence assay in seminal ejaculates of 114 infertile men and 14 healthy controls. Global ROS levels in native seminal ejaculates were mesasured by chemiluminescence assay using luminol as the probe. Results were expressed as relative light units /sec/ × 106 sperm (RLU). Patients were divided into group 1: ROS <250 and group 2: ROS >250 RLU. Receiver operating characteristic (ROC) curve, cutoff value, sensitivity and specificity was calculated.RESULTS: Higher ROS levels (RLU) were seen in infertile men [169.4(30, 1450)] compared to controls [11.2 (0, 258.8)] (P<0.016). The cutoff value of 17.4 RLU with 79.2% sensitivity and 57.1% specificity for the best possible cutoffs with area under the curve of 0.7. Reduced sperm concentration (P<0.002; OR = 0.85 (0.76-0.94), motility (P<0.02; OR = 0.77 (0.65-0.91) and elevated levels of white blood cells (P<0.004; OR = 4.69 (1.64-13.4) were seen in infertile men with ROS >250 (RLU) compared with controls. The incidence of leukocytospermia with the new cutoff <0.2 X 106 wbc/ mL was 73.9% in infertile men compared with controls (26.1%; P<0.001).CONCLUSION: A cutoff of 17 RLU/sec/million spermatozoa differentiates infertile men with oxidative stress from healthy men. High sensitivity allows this test to be offered as a screening tool to diagnose cases of male infertility related to oxidative stress. OBJECTIVE: To establish the clinical utility of offering ROS as a diagnostic marker of oxidative stress in a clinical setting. DESIGN: ROS measurement in seminal ejaculates by chemiluminescence. MATERIALS AND METHODS: Levels of ROS were measured by chemiluminescence assay in seminal ejaculates of 114 infertile men and 14 healthy controls. Global ROS levels in native seminal ejaculates were mesasured by chemiluminescence assay using luminol as the probe. Results were expressed as relative light units /sec/ × 106 sperm (RLU). Patients were divided into group 1: ROS <250 and group 2: ROS >250 RLU. Receiver operating characteristic (ROC) curve, cutoff value, sensitivity and specificity was calculated. RESULTS: Higher ROS levels (RLU) were seen in infertile men [169.4(30, 1450)] compared to controls [11.2 (0, 258.8)] (P<0.016). The cutoff value of 17.4 RLU with 79.2% sensitivity and 57.1% specificity for the best possible cutoffs with area under the curve of 0.7. Reduced sperm concentration (P<0.002; OR = 0.85 (0.76-0.94), motility (P<0.02; OR = 0.77 (0.65-0.91) and elevated levels of white blood cells (P<0.004; OR = 4.69 (1.64-13.4) were seen in infertile men with ROS >250 (RLU) compared with controls. The incidence of leukocytospermia with the new cutoff <0.2 X 106 wbc/ mL was 73.9% in infertile men compared with controls (26.1%; P<0.001). CONCLUSION: A cutoff of 17 RLU/sec/million spermatozoa differentiates infertile men with oxidative stress from healthy men. High sensitivity allows this test to be offered as a screening tool to diagnose cases of male infertility related to oxidative stress.