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Seminal Plasma Cobalamin Significantly Correlates With Sperm Concentration in Men Undergoing IVF or ICSI Procedures

MARIJ SMIT

ROBERTUS F. WEBER

JAN LINDEMANS

JOHANNES C. ROMIJN

MARINUS J. EIJKEMANS

From the Departments of ^* Obstetrics and Gynecology and Reproductive Medicine, Andrology, Clinical Chemistry, Public Health, ^|| Epidemiology and Biostatistics, ^¶ Pediatric Cardiology, and ^# Clinical Genetics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands, and ^** Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands.

Correspondence to: Dr Régine P Steegers-Theunissen, Associate Professor in Reproductive Epidemiology, Erasmus MC, University Medical Center, Department of Obstetrics and Gynecology/Division of Obstetrics and Reproductive Medicine, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands (e-mail: r.steegers{at}erasmusmc.nl).

Mild hyperhomocysteinemia is caused by B vitamin deficiencies. We hypothesize that these biochemical derangements detrimentally affect spermatogenesis. Therefore, the aim of this study was to investigate the folate, cobalamin, pyridoxine, and homocysteine concentrations in blood and seminal plasma and the associations between these biomarkers and semen parameters in men participating in an in vitro fertilization or intracytoplasmic sperm injection program. From 73 men (median age [range]: 37 years [28–53]), blood and semen samples were obtained for the determination of serum and red blood cell (RBC) folate, serum total cobalamin, whole-blood pyridoxal-5'-phosphate, plasma total homocysteine (tHcy), and serum total testosterone. Semen analysis included sperm concentration, motility, and morphology according to World Health Organization criteria. The B vitamins and tHcy concentrations were significantly correlated in blood but not in seminal plasma. The serum and RBC folate concentrations were significantly correlated also with the total folate concentration in seminal plasma (r = .44; P < .001 and r = .39; P < .001, respectively). Likewise, the total cobalamin concentration in serum and seminal plasma was significantly correlated (r = .55; P = .001). Of interest is that the total cobalamin concentration in seminal plasma was significantly correlated with the sperm concentration (r = .42; P < .001). This is in contrast to the absence of significant associations between the other vitamins and tHcy in blood and seminal plasma and any of the semen parameters. These findings suggest that folate and cobalamin are transferred from the blood to the male reproductive organs and emphasize the role of cobalamin in spermatogenesis in human.

     Key words: Assisted reproduction, folate, homocysteine, semen analysis