(1) Leucocytospermia often indicates an inflammatory condition, and is associated with possible infection and poor sperm activity. Bezold et al (2) have concluded that bacteriospermia, especially in sexually transmitted diseases, is a likely cause of male infertility and may jeopardise the pregnancy rate for in vitro fertilisation (IVF).Therefore, the detection of bacteriospermia is of high importance.Cumming and Carrell have concluded that it is more costeffective and prudent to first perform reflexive culture for leucocytospermic patients before proceeding with IVF.However, Lackner et al has shown that an increased PMN has low sensitivity and specificity in predicting bacteria in semen.One study has also demonstrated a 50% false positive rate in culture due to contamination during semen collection.(5) Thus, although it is common practice to order semen culture when PMN is increased, leucocytospermia is a poor marker for bacteriospermia or impaired semen quality. Directly detecting bacteria in semen is not feasible since it requires a Gram stain, which is not commonly used in semen analysis, (1) and has a high false negative rate. Cross-sectional studies by Lackner et al (6) and Gdoura et al (7) have also compared the culture positivity of the semen of patients with and without leucocytospermia.Since there has been no published studies on the Singapore population so far, we aimed to determine whether an increased PMN count in semen is a good predictor of the presence of male genital tract infection, which is detected by semen culture. Is semen polymorphonuclear leucocytes count a good predictor of male genital tract infection?
M E TH O DS