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I am sorry for the misunderstanding and thank the Editor because he gave me the opportunity to explain the mechanisms that provoked my mistake.
My confusion originates from the following wording: "total sperm count x 106/mL" present in the abstract and in table 1, page 916, of the Adamopoulos article (Adamopoulos et al, 2003). In this regard, I have intended "sperm concentration/mL," instead of total ejaculated sperm.
The World Health Organization (WHO) handbook does not list any sperm pattern alike: "total sperm count x 106/mL," and, most importantly, fractional values (ie,... x 106/mL) always indicate a concentration (WHO, 1999).
Almost all articles regarding therapy for oligoasthenospermia take into consideration sperm concentration per milliliter instead of total ejaculated sperm (WHO, 1989, 1992; Rege et al, 1997; Kamischke et al, 1998; Rolf et al, 1999; Vicari and Calogero, 2001; Foresta et al, 2002; Wong et al, 2002; Cavallini et al, 2003; Lenzi et al, 2003, 2004; Zawackzi et al, 2003).
It is uncommon to present data regarding number of total ejaculated sperm, even though an increase in sperm concentrations in OAT (oligo-astheno-teratospermia) infertile males has been thought to be associated with disproportionately higher fecundability (Adamopoulos et al, 2003), because the in vivo and in vitro fertilization proved to be more strictly linked to the quality of spermatogenesis than to the number of ejaculated sperm (Tomlinson et al, 1992; Patrizio et al, 1994; Parinaud et al, 1996a,b; Aboulghar et al, 1997; Verheyen et al, 1997; De Croo et al, 2000).
In this regard, sperm concentration per milliliter is more closely linked to the spermatogenetic process than to the number of total ejaculated sperm (Biagiotti et al, 2002).
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