Sperm motility was measured by using computer-assisted semen analysis (CASA; Sperm Class Analyzer; version evolution 6.0.0.1; Microptic, Barcelona, Spain) according to the WHO classification. An external quality-control service (SCA Maintenance; Microptic, Barcelona, Spain) was performed for this study. Sperm motility was classified into 4 groups. (grade A: fast progressive, grade B: slow progressive, grade C: nonprogressive, grade D: immotile). The CASA settings were according to the manufacturer's instructions. Each reported measurement was an average of five different captured fields. Total motility (A+B+C), progressive motility (A+B), and grade A sperm after in vitro exposure to a PDE5 inhibitor for 0, 30, 60, and 120 minutes were measured.
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