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Volume 21, Issue 6 (November 2019) 21, 565–569; 10.4103/aja.aja_5_19

Multi-center evaluation of oxidation-reduction potential by the MiOXSYS in males with abnormal semen

Ashok Agarwal1, Manesh Kumar Panner Selvam1, Mohamed Arafa2, Hiroshi Okada3, Sheryl Homa4, Aideen Killeen5, Basak Balaban6, Ramadan Saleh7, Abdullah Armagan8, Shubhadeep Roychoudhury9, Suresh Sikka10

1 American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
2 Hamad Medical Hospital, Doha 3050, Qatar
3 Dokkyo Medical University, Koshigaya 343-0845, Japan
4 University of Kent, Canterbury CT2 7NZ, UK
5 The Doctor's Laboratory, London WC1H 9AX, UK
6 American Hospital of Istanbul, Nisantasi 34365, Istanbul, Turkey
7 Sohag University, Sohag 82524, Egypt
8 Bezmialem Vakif University, Fatih 34093, Istanbul, Turkey
9 Assam University, Silchar 788011, India
10 Tulane University, New Orleans, LA 70118, USA

Correspondence: Dr. A Agarwal (agarwaa@ccf.org)



According to the World Health Organization (WHO), oxidative stress (OS) is a significant contributor to male infertility. Seminal OS can be measured by a number of assays, all of which are either costly or time sensitive and/or require large semen volume and complex instrumentation. One less expensive alternative is to quantify the oxidation-reduction potential (ORP) with the MiOXSYS. In this international multi-center study, we assessed whether ORP levels measured by the MiOXSYS could distinguish semen samples that fall within the 2010 WHO normal reference values from those that do not. Semen samples were collected from 2092 patients in 9 countries; ORP was normalized to sperm concentration (mV/106 sperm/ml). Only those samples with a concentration >1 × 106 sperm ml–1 were included. The results showed that 199 samples fell within the WHO normal reference range while the remaining 1893 samples did not meet one or more of the criteria. ORP was negatively correlated with all semen parameters (P < 0.01) except volume. The area under the curve for ORP was 0.765. The ORP cut-off value (1.34 mV/106 sperm/ml) was able to differentiate specimens with abnormal semen parameters with 98.1% sensitivity, 40.6% specificity, 94.7% positive predictive value (PPV) and 66.6% negative predictive value (NPV). When used as an adjunct to traditional semen analysis, ORP levels may help identify altered functional status of spermatozoa caused by OS in cases of idiopathic male infertility and in male partners of couples suffering recurrent pregnancy loss, and thereby directing these men to relevant medical therapies and lifestyle modifications.

Keywords: male infertility; oxidation-reduction potential; semen analysis; spermatozoa

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