Correlation of leukocytospermia with clinical infection and the positive effect of antiinflammatory treatment on semen quality

ObjectiveTo investigate the correlation between leukocytospermia, bacteriospermia, and clinical signs of infection and to evaluate antiinflammatory therapy.DesignProspective nonrandomized study.SettingAndrologic clinic at university hospital.Patient(s)A total of 56 patients were evaluated, and 12 of them received further treatment with a Cox-2 inhibitor.Intervention(s)Semen analysis and clinical investigation were done according to World Health Organization guidelines. Serum levels of leukocytes, C-reactive protein (CRP), and prostate-specific antigen (PSA) were measured from blood samples.Main Outcome Measure(s)Sperm concentration, leukocyte concentration, serum leukocyte count, CRP, PSA, bacterial growth.Result(s)Leukocytospermia (>1 × 106/mL) was present in 60.7% of the semen samples, significant pathogenic bacterial growth was detectable in 35.7%, and 14.3% of the samples fulfilled the criteria for ejaculate signs of infection. All serum parameters were within the normal range. In abacterial leukocytospermia, treatment with a Cox-2 inhibitor decreased leukocytospermia from 5.5 × 106/mL to 1.0 × 106/mL (P=.001) and increased sperm concentration from 22.5 × 106/mL to 48.0 × 106/mL (P=.02).Conclusion(s)There was no evidence of an immune response in the peripheral blood system. In abacterial leukocytospermia, treatment with a Cox-2 inhibitor seems to be able to reduce leukocytospermia and increase sperm count.