Adenosine triphosphate in semen and other sperm characteristics: Their relevance for fertility prediction in men with normal sperm concentration

Objective: To evaluate the power of sperm characteristics and of the semen content of adenosine triphosphate (ATP) in predicting the occurrence of pregnancy in infertile couples. Design: This is a prospective study monitoring the occurrence of pregnancy during 400 days of follow-up. Settings: Couples were recruited in 10 centers, and data were analyzed at the World Health Organization Headquarters. Patients: Of 361 couples recruited, 306 satisfied the following criteria: infertility of at least 12 months' duration, anatomically normal female ovulating regularly, sperm concentration > 20 x 10(6)/mL, valid semen data, and ATP available before conception. Interventions: None. Main Outcome Measure: The occurrence of pregnancy. Results: Ninety-six couples (31.4%) achieved conception. Duration of infertility < 3 years was associated with higher conception rate (41.1%) than longer duration (28.2%). None of the semen characteristics nor the ATP content predicted the occurrence of pregnancy. Conclusions: Neither conventional sperm characteristics nor semen ATP can predict the occurrence of pregnancy among couples in which the female partner is normal and the male partner has sperm concentration > 20 x 10(6)/mL.