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Updated: May 11, 2026

The Examination of Peroxidase-Positive Leukocytes in Semen
Published on: January 19, 2024
Semen quality of 1559 young men from four cities in Japan: a cross-sectional population-based study
Teruaki Iwamoto1, Shiari Nozawa, Makiko Naka Mieno
1Division of Male Infertility, Centre for Infertility and IVF, International University of Health and WelfareHospital, Nasushiobara, Japan.
Objectives:
To provide information of semen quality among normal young Japanese men and indicate the frequency of reduced semen quality.
Design:
Cross-sectional, coordinated studies of Japanese young men included from university areas. The men had to be 18-24 years, and both the man and his mother had to be born in Japan. Background information was obtained from questionnaires. Standardised and quality-controlled semen analyses were performed, reproductive hormones analysed centrally and results adjusted for confounding factors.
Setting:
Four study centres in Japan (Kawasaki, Osaka, Kanazawa and Nagasaki).
Participants:
1559 men, median age 21.1 years, included during 1999-2003.
Outcome Measures:
Semen volume, sperm concentration, total sperm count, sperm motility, sperm morphology and reproductive hormone levels.
Results:
Median sperm concentration was 59 (95% CI 52 to 68) million/ml, and 9% and 31.9% had less than 15 and 40 million/ml, respectively. Median percentage of morphologically normal spermatozoa was 9.6 (8.8 to 10.3)%. Small, but statistically significant, differences were detected for both semen and reproductive hormone variables between men from the four cities. Overall, the semen values were lower than those of a reference population of 792 fertile Japanese men.
Conclusions:
Assuming that the investigated men were representative for young Japanese men, a significant proportion of the population had suboptimal semen quality with reduced fertility potential, and as a group they had lower semen quality than fertile men. However, the definitive role-if any-of low semen quality for subfertility and low fertility rates remain to be investigated.
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