The incidence and effect of bacteriospermia and elevated seminal leukocytes on semen parameters

ObjectiveTo determine the incidence of bacteriospermia and elevated seminal leukocytes (ESL) in a subfertile male population and correlate these results with semen parameters.DesignRetrospective cohort study.SettingCanadian tertiary-level male infertility clinic and university-affiliated andrology and microbiology laboratories.Patient(s)Four thousand nine hundred thirty-five nonazoospermic subfertile men.Intervention(s)Analysis and concurrent culture of 7,852 semen samples.Main Outcome Measure(s)Incidence of bacteriospermia and ESL and comparison of semen parameters between these groups.Result(s)The rate of bacteriospermia was 15% (22 species), and the rate of ESL was 19%, with no statistical correlation between these groups. Bacteriospermic patients (without ESL) had a statistically significant deterioration in DNA fragmentation index (DFI) only, compared with patients without bacteriospermia and ESL (24.1 vs. 21.8%). ESL alone was associated with a statistically significant deterioration in sperm concentration (20.6 vs. 55.3 × 106/mL), motility (21.8 vs. 26.9%), normal morphology (12.3 vs. 17.4%), and DFI (26.5 vs. 21.8%), with no additional deterioration identified with bacteriospermia.Conclusion(s)Bacteriospermia and ESL were prevalent, but not statistically associated, in subfertile men. Bacteriospermia alone was associated with an increase in DFI only, but the presence of ESL was the dominant factor associated with deterioration in semen parameters.