Pyospermia in Men Seeking Assisted Reproduction Technology

Abstract

Introduction: Pyospermia is often detected in semen, especially when investigating for male infertility. Pyospermia, in a significantly large number is often correlated with inferior sperm parameters and reduced fertility. Pyospermia may be a factor of a fundamental genitourinary infection. This study assessed the relationship between pus cells and semen parameters in infertile Nigerian males. Subjects and Methods: A cross-sectional descriptive study was carried out at Nordica Fertility Center, Lagos, Nigeria, from 2004 to 2009. A total of 907 subjects were analyzed. Subjects ages (years) were categorized into ≤30, BMI into <18.5 (underweight), and ≥30 (obese) and pus cells into none, 1 -2 and ≥3. Results: Leucocytopenia of ≥3 per high power field (/hpf) occurred in 67 (7.4%) men. The overall means (±sd) of pus cells was 1.4 (0.9), 1.4 (0.7), 1.4 (0.7) and 1.6 (1.6) per high power field in all, normospermia, oligoospermic and azoospermic clusters of patients respectively. Mean (±sd) pus cells in semen was 6.0 (4.0), the highest, among obese (BMI ≥ 30) azoospermic patients. The proportion of subjects with pyospermia of 1 -2 was highest (323/346, 93.3%) among oligoospermic patients while that with pyospermia of ≥3 was highest (10/109, 9.2%) among azoospermic patients. Obese azoospermic patients were 1.8 times as likely to have ≥3/hpf pyospermia compared to normal normospermic patients (x² = 0.05, P-value = 0.51, OR = 1.82, 95% CI: 0.30, 11.02). Mean progressive motility (%) was significantly reduced (t = 1.95, P-value = 0.03) among patients with ≥3/hpf pyospermia (33.75 ± 19.23) compared to those with 1 -2/hpf pyospermia (38.58 ± 21.63). Patients with sperm oval head ≤ 30% had significantly higher pyospermia (t = 2.22, P-value = 0.013) than those with sperm oval head of >30%. Conclusion: Elevated pus cell counts were observed among obese