Reactive oxygen species (ROS) production in seminal fluid correlate with the severity of varicocele in infertile men

Background: Reactive oxygen species (ROS) are a group of free radicals that in excessive amounts have negative influence on sperm quality and function. Objective: To study the effect of varicocele and its severity on the level of ROS in infertile men with clinical varicocele. Materials and Methods: In this controlled prospective study, 42 men with clinically diagnosed left varicocele and 30 fertile men were studied. Patients were asked about history of urogenital infection, using any antioxidant medication and smoking. Grade of varicocele was determined by physical examination. Levels of ROS in seminal plasma were measured in each group by a chemiluminiscence assay. The sperm parameters were also determined and compared in different groups. Results: The ROS levels were significantly higher in patients with varicocele than normal men (mean: 1575.42 RLU (Radio Luminescence Unit) vs. 53.79 RLU, p=0.005). In total 20 patients had grade I, 20 patients grade II and 2 patients had grade III varicocele. The mean ROS levels were 669.12 RLU, 2406.87 RLU and 2324 RLU in patients with grade I, II and III varicocele respectively (p=0.144). In case group, 15 patients were smoker and 27 were non-smokers. The mean ROS levels in patients with the history of smoking was 1367.71 RLU while in non-smokers it was 897.672 RLU (p=0.729). Conclusion: Our study showed that increased levels of ROS production in the seminal fluid can be an important factor in the etiology of male infertility in patients with varicocele, and this effect is more prominent with higher grade of varicocele.