Paradoxical increase of sperm motility and seminal carnitine associated with moderate leukocytospermia in infertile patients

ObjectiveTo examine the relationship between seminal polymorphonuclear (PMN) granulocytes and sperm functions (particularly sperm motility) in infertile men.DesignA prospective clinical study.SettingAssisted fertilization program in an academic research environment in France.Patient(s)Infertile men (n = 138) evaluated and classified as follows: group A with no detectable PMN in semen, group B with less than 0.5 × 106/mL, group C with 0.5-1 × 106/mL, and group D > 1 × 106/mL.Intervention(s)Seminal PMN, elastase concentrations, and sperm characteristics were analyzed. Seminal biochemical markers (free L-carnitine, citrate, zinc, acid phosphatase, and fructose) were measured.Main Outcome Measure(s)Relation between seminal markers and sperm motility.Result(s)Grade “b” motility and epididymal carnitine were statistically significantly increased in group C. Acid phosphatase was the only seminal marker to be statistically significantly impaired in group D. Elastase was proportional to the degree of leukocytospermia.Conclusion(s)These results suggest that sperm PMN originate from two regions: [1] the epididymis, where in small numbers and activated they may play a favorable role in sperm quality, and the [2] prostate, where their presence in large numbers, reflecting prostatitis, induces decreased secretion, especially of acid phosphatase.