JM Potts, FF Pasqualotto, RK Sharma,
DR Nelson, AJ Thomas, A Agarwal
Cleveland Clinic Foundation,
Department of Urology, Cleveland, OH
An association between prostatitis and male infertility has been suspected, yet poorly understood. Prostatitis may be associated with granulocytes in the seminal fluid, which are capable of producing reactive oxygen
species (ROS). ROS has been proven to impair sperm function and may be an important factor in the setting of chronic abacterial prostatitis.
Methods After excluding patients with positive semen cultures,
specimens from 44 symptomatic men (NIH Category III) and 19 healthy donors were examined according to World Health Organization criteria. Leukocytospermia was measured by the Endtz test (myeloperoxidase assay). ROS and
total antioxidant capacity (TAC) production were measured by chemiluminescence assay.
Results Five of the prostatitis patients had a positive Endtz test. Multivariate analysis found no difference in sperm
characteristics (concentration, percentage motility, and morphology) between patients with or without leukocytospermia when compared to the control led group. Mean (+ standard error) log-transformed ROS levels were
significantly higher in patients with leukocytospermia (3.2 + 0.6) than in patients without leukocytospermia (1.8 + 0.2; p=0.04) and controls (1.3 + 0.3; p=0.01). TAC was significantly lower in patients with or without
leukocytospermia (859.69 + 193.0 and 914.9 + 65.2) than in controls (1653.98 + 93.6; p= 0.001).
Conclusions Semen specimens from men with chronic abacterial prostatitis (NIH Category III) exhibited seminal
oxidative stress irrespective of their leucocyte status. These observations may help shed light on the long- standing controversy surrounding prostatitis and infertility.