Relevance of Leukocytospermia and Semen Culture and Its True Place in Diagnosing and Treating Male Infertility

Relevance of Leukocytospermia and Semen Culture and Its True Place in Diagnosing and Treating Male Infertility
Authors: Sharma R, et al, World J Men’s Health, Published online Jun 9, 2021
https://doi.org/10.5534/wjmh.210063

Capsule: Leukocytospermia refers to the presence of an increased number of white blood cells (leukocytes) in semen. Normally, a small number of leukocytes can be found in semen samples, but when the concentration exceeds a certain threshold, it is considered leukocytospermia. Leukocytospermia can be significant in the context of male infertility for several reasons: 1) Infection: the presence of elevated white blood cells may indicate an underlying infection in the male reproductive tract, such as prostatitis, epididymitis, or seminal vesiculitis. These infections can impair sperm production, motility, and function, thereby affecting fertility; 2) inflammatory response: leukocytes play a crucial role in the body's immune response to infection or injury. However, excessive or sustained inflammation in the male reproductive tract can lead to the release of harmful substances, such as reactive oxygen species (ROS) and pro-inflammatory cytokines. These substances can damage sperm cells, impair their function, and reduce fertility; 3) oxidative stress: White blood cells produce ROS as part of their defense mechanism against pathogens. However, high levels of ROS can cause oxidative stress, which can negatively affect sperm quality and function. Oxidative stress can lead to DNA damage, lipid peroxidation, and alterations in sperm membrane integrity, all of which can contribute to male infertility; 4) antisperm antibodies: In some cases, leukocytospermia can trigger an immune response in which the body produces antibodies against sperm cells (antisperm antibodies). These antibodies can bind to sperm cells, impair their motility, and function, and interfere with fertilization. It's important to note that leukocytospermia alone does not directly indicate infertility, as it can be present in both fertile and infertile men. However, it serves as an indicator of potential underlying issues in the male reproductive system that may contribute to fertility problems. If leukocytospermia is suspected, further investigations, including semen culture, testing for inflammation markers, and evaluation for genital tract infections, should be conducted to determine the cause and appropriate treatment. Leukocytospermia is associated with high levels of ROS, leading to DNA damage and poor sperm quality. Detecting leukocytes in semen is important as they can indicate underlying inflammation or infection. Investigating leukocytospermia helps diagnose the cause of male infertility and is part of optimal management. The peroxidase staining test provides reliable results, although it's not the gold standard. While leukocytospermia doesn't predict a positive semen culture alone, resolving it can aid in managing infertility.