Increased polymorphonuclear granulocytes in seminal plasma in relation to sperm morphology

Abstract

Much controversy surrounds the clinical significance of an increased concentration of white blood cells (WBC) in the male ejaculate. The World Health Organization's classification of leukocytospermia is a concentration > 1 x 10(6) WBC/ml. The aim of this study was to assess the association of varying concentrations of leukocytes to sperm morphology evaluated by strict criteria. Semen samples were collected from a total of 79 patients. Round cells on the initial semen analysis were stained for identification of polymorphonuclear granulocytes (PMN) as the largest group (50-60%) of white blood cells using the Endtz Method commercially produced as Leucoscreen. Diff Quick Staining Kit was used for sperm morphology assessment and 200 spermatozoa were assessed per slide. Data were evaluated using two cut-off criteria, at 0.5 x 10(6) WBC/ml and 1 x 10(6) WBC/ml. Mann-Whitney U-values at both < and > 0.5 x 10(6)/ml PMN (P < 0.001) and at < and > 1.0 x 10(6)/ml PMN (P < 0.015) showed differences between percentage normal forms. Spearman's rank correlation coefficient for PMN concentration showed a negative correlation (P < 0.01) with percentage normal sperm morphology and positive correlation for midpiece abnormalities (P < 0.04). These data support the hypothesis that PMN have a role in the increase of abnormal spermatozoa, particularly those with midpiece abnormalities, by as yet unknown mechanisms.

Role of reactive oxygen species in the pathophysiology of human reproduction

“…However, the clinical significance of increased leukocyte infiltration in semen, that is, leukocytospermia, is currently the subject of controversy (48). On one hand, leukocytospermia has been linked with poor sperm quality, reduced sperm hyperactivation, and defective sperm function (49).…”

“…Peroxidase-positive leukocytes include polymorphonuclear leukocytes, which represent 50% to 60% of all seminal leukocytes, and macrophages, which represent another 20% to 30% (48). Peroxidase-positive leukocytes in semen are contributed largely by the prostate and the seminal vesicles (49).…”

REVIEW ARTICLE: Clinical Relevance of Oxidative Stress in Male Factor Infertility: An Update

“…Controversy exists over the clinical significance of leukocytospermia. 23 Sperm parameters such as poor quality, decreased hyperactivation, and defective sperm function 24 have been attributed to leukocytospermia. On the other hand, no correlation was reported between seminal leukocyte concentrations and impaired sperm quality 25 or defective sperm function.…”

“…23 These PMNL are mainly contributed to the human ejaculate by the prostate gland and the seminal vesicles. 24 Infection and inflammation may activate the leukocytes, 29 and these activated leukocytes can produce up to 100-fold higher amounts of ROS compared with non-activated leukocytes.…”

Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia

“…The prevalence of LCS in male infertility patients varies from 2% to 40% in published reports (9,(11)(12)(13), and elevated concentrations of WBC in semen have been associated with reduced sperm function and quality (9,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23).…”