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

Objective: To investigate the correlation between leukocytospermia, bacteriospermia, and clinical signs of infection and to evaluate antiinflammatory therapy. Design: Prospective nonrandomised study. Setting: Andrologic 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 level of leukocytes, C-reactive protein (CRP), and prostrate-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): Leukocytospermic (> 1 x 10(6)/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 leukocytospermic from 5.5 a 10(6)/mL to 1.0 x 10(6)/mL (P=.001) and increased sperm concentration from 22.5 x 10(6)/mL to 48.0 x 10(6)/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.