Leukocytospermia

Abstract

The role of leukocytes in semen (leukocytospermia) is still controversial. Contradictory reports on leukocytospermia have been published indicating negative effects on semen parameters and even in vitro fertilization (IVF) results, while other investigators did not find any negative influences of leukocytospermia on semen parameters. A few papers indicated a positive role for seminal leukocytes by elimination of morphological abnormal spermatozoa by phagocytosis. However, from the most recent literature, it is now clear that the most important deleterious effect of leukocytospermia may be the production of reactive oxygen species (ROS) causing DNA fragmentation of spermatozoa, leading to significant reduced pregnancy rates with IVF and intracytoplasmic sperm injection (ICSI) when oocytes are inseminated with spermatozoa from leukocytospermic semen samples. Contradictive results on treatment of leukocytospermia by antibiotics have also been published. However, a survey of the literature indicated that more evidence is presented testifying that antibiotic treatment of leukocytospermia may be beneficial by lowering the number of seminal leukocytes and even improving semen parameters. Therefore, treating leukocytospermia seems indicated. D 2004 Published by Elsevier B.V.

Major regulatory mechanisms involved in sperm motility

“…Other conditions that also increase sperm oxidative stress can be treated by surgery (varicocele)73 by the use of corticosteroids (presence of anti-sperm antibodies following chronic genital tract inflammations)151152153 and the correct and timely use of antibiotics for genital tract infections 154155156…”

Mechanisms of the harmful effects of bacterial semen infection on ejaculated human spermatozoa: potential inflammatory markers in semen

“…On the one hand, some authors demonstrated poor sperm morphology characteristics in the presence of several types of bacteria (Table 1). Also, the improvement in sperm parameters including sperm morphology abnormalities in men with urogenital tract infections after long-term antibiotic treatment has been observed [40]. On the other hand, sperm morphology alterations associated with elongation and reduced acrosomal inducibility have been found in men with inflammatory chronic prostatitis/chronic pelvic pain syndrome, and these changes were attributed rather to leukocytes [41].…”

Clinical significance of the low normal sperm morphology value as proposed in the fifth edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen

“…Low ICSI fertilization rates have also been found in men with severely elongated sper ma tozoa compared with other sperm morphology abnormalities [64]. However, when the MAGI is treated with long-term antibiotics or the varicocele is treated with a varicocelectomy, semen characteristics, including sperm morphology, can improve and pregnancies can result [65]. In case of varicocelectomies, in which no substantial improvement in semen quality is observed, pregnancies do still occur because sperm DNA quality improves because of the reduction of ROS production following the varicocelectomy [66].…”

“…Although not actually a sperm morphology parameter, determination of the presence of leukocytes, especially polymorphonuclear leukocytes, is an important aspect of the sperm morphology evaluation procedure [65]. Polymorphonuclear leukocytes are the main source of ROS production in semen, leading to increased sperm DNA damage.…”

“…Polymorphonuclear leukocytes are the main source of ROS production in semen, leading to increased sperm DNA damage. Although sometimes reported as part of the morphology evaluation procedure, much more emphasis should be placed on the presence of polymorphonuclear leukocytes in semen and the importance of antibiotic treatment for leukocytospermia and the subsequent possible improvement in pregnancy outcome [65,70].…”