Leukocytospermia is a condition in which the semen contains high numbers of white blood cells (WBCs), typically over one million WBCs per ml. It may reflect infection or inflammation of the male reproductive and urinary system. Infection within the male reproductive tract accounts for around 15% of cases of infertility in men.
Leukocytospermia can impact sperm function and fertility potential.
FertilitySmarts explains Leukocytospermia
White blood cells are a key component of the immune system. They help to defend the body from disease-causing agents like bacteria and viruses. They are also found in the semen at low concentrations and are required to remove germs from the ejaculate.
At low levels, the WBCs in semen do not affect fertility. The presence of an infection in the body tends to increase the white blood cell count in some areas. While leukocytospermia can be the result of a genital tract infection such as chlamydia or gonorrhea, there are many cases in which the cause of leukocytospermia is unclear.
High levels of white blood cells in the seminal fluid can cause the production of highly reactive and damaging molecules called free radicals—a process called oxidative stress. These molecules can damage the sperm, decreasing the count and motility, and interfere with male fertility.
Measuring the WBC count in the semen is critical to evaluating and managing leukocytospermia.
If an infection is found, antibiotics can be used to treat the infection. Some men who have no clear infection may still be treated with a long course of antibiotics in an effort to lower the WBC count and treat inflammation. Antioxidants like vitamin E and coenzyme Q10 may help fight oxidative damage.
Although in vitro fertilization (IVF) via intracytoplasmic sperm injection (ICSI) is the treatment of choice for male factor infertility, repeated IVF failures are common. Importantly, studies suggest that treating leukocytospermia before IVF does not improve fertility outcomes.
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Jung JH, et al.
Treatment of Leukocytospermia in Male Infertility: A Systematic Review.