Leukocytospermia and hematospermia are defined as the presence of abnormally high white blood cell and red blood cell concentration in the semen, respectively. Numerous etiologies and various implications on fertility have been identified. In a small proportion of men, the presence of white blood cells or red blood cells can adversely affect sperm quality by the production of reactive oxygen species. Several methods have been used to assess the presence of white blood cells and red blood cells in samples, such as identification of round cells, immunohistochemical staining using monoclonal antibodies, the Endtz test, the peroxidase test, and flow cytometry or microscopy. In addition, techniques have been identified to separate sperm samples from white blood cells and red blood cells for cryopreservation to improve outcomes in assisted reproductive technology. In this review, laboratory and clinical management of leukocytospermia and hematospermia are discussed. Currently available diagnostic methods and treatment options are outlined, and available optimal cryopreservation techniques for samples with white blood cells or red blood cells are summarized.

Spermatogenesis is the complex process by which spermatozoa develop in the seminiferous tubules of the testis. It is the essential component in the establishment and maintenance of male fertility. Spermatogenesis is tightly regulated by hormones and growth factors from the anterior pituitary gland or within the testes itself. The steps of spermatogenesis can be divided as follows: spermatogonial renewal and proliferation via mitosis and differentiation, cell cycle progression from type B spermatogonia to primary spermatocytes, cell cycle progression to produce secondary spermatocytes, development of spermatozoa via spermiogenesis and spermiation (spermatozoa maturation) (Cheng & Mruk, 2012).

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Male factor infertility accounts for about 50% of the incidence of infertility in couples. In current practice, the men must attend a clinic or hospital facility to provide a semen analysis, which is key to the diagnosis of the male reproductive potential. However, many men are often embarrassed with the process and conventional semen analysis requires complex, labor intensive inspection with a microscope. To mitigate these problems, one of the solutions can be at-home semen analysis. In this review we examine the literature of currently available at home semen analysis test kits, describe their limitations, and compare them to the conventional lab-based methods.

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