Spontaneous variation of leukocytospermia in asymptomatic infertile males

ObjectiveTo investigate the spontaneous variation of leukocytospermia (>1 million/mL) in semen samples from infertile men.DesignProspective cohort study.SettingAndrologic clinic at university hospital.Patient(s)Ninety-nine men evaluating for infertility causes.Intervention(s)Two semen analyses according the World Health Organization criteria combined with urologic investigation without any treatment.Main Outcome measure(s)Spontaneous (downward/upward) variation in leukocyte count, sperm concentration, total motility, and morphology between the two semen samples.Result(s)In the first semen analysis, 21% of men had leukocytospermia. By the second analysis, leukocyte concentrations were within the normal range in 9 of these 21 men, corresponding to a downward variation of 43%. In contrast, 7 of 78 patients with normal leukocyte levels at the first analysis had leukocytospermia at the second analysis, corresponding to an upward variation of 9%. The upward variation rates for sperm concentration, total motility, and morphology were 4%, 17%, and 4%, respectively. Downward variation rates were considerably higher for total motility and morphology (30% and 28%, respectively).Conclusion(s)The rate for spontaneous downward variation of leukocytospermia in the absence of treatment was 43% in this study. This rate should be taken into consideration when treating infertile men with leukocytospermia, because effective medical therapy is still lacking.