Relationship between semen cultures, leukospermia, and semen analysis in men undergoing fertility evaluation

Objective: To determine the correlation between semen cultures, semen Gram stains, leukospermia, and semen analysis parameters in asymptomatic men undergoing fertility evaluation. Design: Prospective clinical study. Setting: Infertility clinic at a university teaching hospital. Patient(s): Two hundred ninety-nine asymptomatic men undergoing fertility evaluation. Intervention(s): After an antibacterial skin preparation, all men gave semen specimens for culture, Gram stains, semen analysis, and assessment for leukospermia. Main Outcome Measure(s): A comparison of the presence or absence of bacteriospermia, the specific bacterial isolate, the quantity of bacteriospermia, the presence or absence of leukospermia, and semen analysis parameters. Result(s): The presence or absence of bacteriospermia or leukospermia did not correlate with each other. Leukospermia did not correlate with semen parameters. Staphylococcus species was the most common isolate (25.4% of all patients) and did not correlate with semen parameters or leukospermia. Streptococcus viridans (15.4% of all patients) and Enterococcusfaecalis (7.4% of all patients) were the next most common isolates and were associated with statistically significantly poorer semen quality. Conclusion(s): Leukospermia is a poor marker for either bacteriospermia or impaired semen quality. Staphylococcus species are commonly isolated but appear to be innocuous. Streptococcus viridans and Enterococcus faecalis are associated with poorer semen quality and may warrant treatment.