Relevance of Leukocytospermia and Semen Culture and Its True Place in
Diagnosing and Treating Male Infertility
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Abstract
The current WHO 2010 manual for human semen analysis defines
leukocytospermia as the presence of peroxidase-positive leukocytes at a
concentration >1x10(6)/mL of semen. Granular leukocytes when activated
are capable of generating high levels of reactive oxygen species in
semen resulting in oxidative stress. Oxidative stress has been
correlated with poor sperm quality, increased level of sperm DNA
fragmentation and low fertility potential. The presence of leukocytes
and pathogens in the semen may be a sign of infection and/or localized
inflammatory response in the male genital tract and the accessory
glands. Common uro-pathogens including Chlamydia trachomatis, Ureaplasma
urealyticum, Neisseria gonorrhoeae, Mycoplasma hominis, and Escherichia
coli can cause epididymitis, epididymo-orchitis, or prostatitis. The
relationship between leukocytospermia and infection is unclear.
Therefore, we describe the pathogens responsible for male genital tract
infections and their association with leukocytospermia. The review also
examines the diagnostic tests available to identify seminal leukocytes.
The role of leukocytospermia in male infertility and its management is
also discussed