This study was designed to determine if the value obtained after multiplying motile sperm concentration by seminal
fructose concentration, named "true corrected
fructose", correlates with sperm motility in asthenozoospermic men. Forty-two male partners in infertile couples were studied. Men were treated with 100 mg daily of
clomiphene citrate for 5 days. Blood and semen samples were collected before treatment and 24 h after the end of treatment. Serum
testosterone, seminal
fructose and sperm motility were measured in each subject. Corrected
fructose (log. sperm concentration multiplied by seminal
fructose), and true corrected
fructose (log. motile sperm concentration multiplied by seminal
fructose) values were calculated. Prevalence of
asthenozoospermia was 42.85% (18 of 42). Prevalence of hypofunction of the seminal vesicles was 9.5% using seminal
fructose as a marker; 40.5% using seminal corrected
fructose as a marker and 47.6% using true corrected
fructose as a marker of seminal vesicle function. Regression analysis showed a better coefficient of determination between true corrected
fructose and motile sperm concentration (R2=0.20, p < 0.001) than with corrected
fructose (R(2)=0.05, p < 0.1) or
fructose concentration (R(2)=0.006, p < 0.5).
Asthenozoospermia was observed in 22.7% of subjects with normal function of the seminal vesicles, and in 65% of men with low values of true corrected
fructose (z=6.02, p < 0.0001). Multivariate analysis showed that sperm motility grade 3 improved
after treatment with
clomiphene if true corrected
fructose increased (p < 0.002). In those men whose seminal vesicle function improved after
clomiphene treatment, a reduction in the prevalence of
asthenozoospermia from 50 to 28.6% (z=3.10, p < 0.002) was observed whereas in those whose seminal vesicles did not respond to
clomiphene the prevalence of
asthenozoospermia was not reduced (z=1.05; p: NS). In conclusion, true corrected
fructose measurement relates with sperm motility in cases of
asthenozoospermia.
Asthenozoospermia improves with
clomiphene treatment if seminal vesicle function improves
after treatment.