Effects of leukocytospermia on the outcomes of assisted reproductive technology

Qiao, Xiaoyong; Zeng, Rujun; Xu, Liangzhi; Ma, Qin; Yang, Yingzi; Bai, Yu; Yang, Yihong; Bai, Peng

doi:10.1111/and.14403

Cited by 6 publications

(5 citation statements)

References 37 publications

(52 reference statements)

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“…Our findings are consistent with several prior studies which have similarly demonstrated no adverse impact of leukocytospermia on clinical outcomes and fertilization rates [ 2 , 9 ]. While some studies have shown reduced semen analysis parameters and negative clinical outcomes in the presence of leukocytospermia [ 3 – 8 , 11 ], our results did not demonstrate this. The potential impact of various sperm processing techniques, sample sizes, and patient etiologies may account for the differing results seen in prior studies.…”

Section: Discussioncontrasting

confidence: 99%

“…Other studies, however, have suggested no adverse impact on fertilization rate, quality of embryos, and clinical outcomes including implantation rate when comparing IVF cycles in the presence of leukocytospermia to those cycles without leukocytospermia [ 2 , 9 , 10 ]. One study demonstrated that despite lower semen analysis parameters in the leukocytospermia group at the time of IVF and ICSI, there was no significant difference in the clinical pregnancy rate and live birth rate compared to the non-leukocytospermia group [ 11 ]. A recent meta-analysis of 28 case-control studies comparing the fertilization rate after ART for 254 leukocytospermic cases and 3613 non-leukocytospermic controls also found no significant difference between the two groups [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Leukocytospermia does not negatively impact outcomes in in vitro fertilization cycles with intracytoplasmic sperm injection and preimplantation genetic testing for aneuploidy: findings from 5435 cycles

Gill,

Puchalt,

Molinaro

et al. 2024

J Assist Reprod Genet

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Purpose To investigate whether leukocytospermia (defined as the presence of ≥ 1 × 106 white blood cells/mL) affects clinical and embryologic outcomes in in vitro fertilization (IVF) cycles with intracytoplasmic sperm injection (ICSI) and preimplantation genetic testing for aneuploidy (PGT-A). Methods This was a retrospective cohort study including 5425 cycles between January 2012 to December 2021 at a single large university-affiliated fertility clinic. The primary outcome was live birth rate (LBR). Results The prevalence of leukocytospermia was 33.9% (n = 1843). Baseline characteristics including female age, BMI, AMH, Day 3 FSH, and male partner’s age were similar in cycles with and without leukocytospermia. The LBR after the first euploid embryo transfer was similar in those with and without leukocytospermia (62.3% vs. 63% p = 0.625). Secondary outcomes including clinical pregnancy rate (CPR), sustained implantation rate (SIR), fertilization (2PN) rate, blastulation rate, and aneuploidy rate were also evaluated. The CPR (73.3% vs 74.9%, p = 0.213) and SIR (64.6% vs. 66%, p = 0.305) were similar in both groups. The 2PN rate was also similar in both groups (85.7% vs. 85.8%, p = 0.791), as was the blastulation rate per 2PN (56.7% vs. 57.5%, p = 0.116). The aneuploidy rate was not significantly different between groups (25.7% vs 24.4%, p = 0.053). A generalized estimation equation with logistic regression demonstrated that the presence leukocytospermia did not influence the LBR (adjusted OR 0.878; 95% CI, 0.680–1.138). Conclusion Leukocytospermia diagnosed just prior to an IVF cycle with PGT-A does not negatively impact clinical or embryologic outcomes.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Leukocytospermia does not negatively impact outcomes in in vitro fertilization cycles with intracytoplasmic sperm injection and preimplantation genetic testing for aneuploidy: findings from 5435 cycles

Gill,

Puchalt,

Molinaro

et al. 2024

J Assist Reprod Genet

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“…Liu et al [ 13 ] showed that there were no correlations between the leukocyte concentration, basic semen parameters, sperm cell number, and damaged DNA and 8-OHdG expression in a group of infertile men. Furthermore, some researchers did not indicate that leukocytes significantly influence assisted reproductive technology outcomes [ 66 , 67 ]. Both in original research [ 66 ] and meta-analysis [ 67 ], the harmful effect of leukocytospermia on in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) was not confirmed.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, some researchers did not indicate that leukocytes significantly influence assisted reproductive technology outcomes [ 66 , 67 ]. Both in original research [ 66 ] and meta-analysis [ 67 ], the harmful effect of leukocytospermia on in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) was not confirmed. Groups of patients, irrespective of leukocytospermia, did not differ in assessed embryo parameters, the course of pregnancy, or live birth rates.…”

Section: Discussionmentioning

confidence: 99%

Male Infertility Coexists with Decreased Sperm Genomic Integrity and Oxidative Stress in Semen Irrespective of Leukocytospermia

et al. 2022

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Our research was designed to verify the relationship between male infertility, basic semen characteristics (with respect to detailed sperm morphology), sperm DNA fragmentation (SDF), oxidation‒reduction potential in semen (ORP), and leukocytospermia. The obtained results showed that infertile groups (with or without leukocytospermia) had significantly lower basic semen characteristics and higher SDF, raw ORP, and static ORP (sORP) than fertile controls. The thresholds of 13% SDF (AUC = 0.733) and 1.40 sORP (AUC = 0.857) were predictive values for discriminating infertile from fertile men. In infertile groups, a higher prevalence and risk for >13% SDF and >1.40 sORP were revealed. Unexpectedly, leukocytospermic subjects had lower sORP, prevalence, and risk for >1.40 sORP than leukocytospermic-negative men. These groups did not differ in SDF and raw ORP. Both SDF and sORP negatively correlated with basic semen parameters but positively correlated with sperm head and midpiece defects. sORP positively correlated with sperm tail defects, immature sperm cells with excess residual cytoplasm, and SDF. In turn, raw ORP negatively correlated with sperm count but positively correlated with SDF and sORP. These findings indicate that (1) there is a relationship between male infertility, SDF, and OS in semen; (2) in infertile men, there is a clinically significant risk of SDF and OS irrespective of leukocytospermia; and (3) the assessment of SDF and oxidative stress should be independent of leukocytospermia.

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“…On the contrary, Yilmaz et al found a negative impact of leukocytospermia on fertilization and embryo development rates after ICSI [183]. Yet, other reports demonstrated that the presence of more than 10 6 leukocytes/mL in the ejaculate that were used for insemination has no effect on the outcome of assisted reproduction by IVF and ICSI [252][253][254][255]. In a metaanalysis including 254 leukocytospermic and 3613 non-leukocytospermic patients in six and five studies, respectively, Castellini et al did not observe an effect of the presence of an excessive number of leukocytes on the fertilization rate after IVF or ICSI outcomes (six studies) [256].…”

Section: Relevance Of Leukocytospermiamentioning

confidence: 99%

Leukocytospermia and/or Bacteriospermia: Impact on Male Infertility

Henkel

2024

JCM

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Infertility is a globally underestimated public health concern affecting almost 190 million people, i.e., about 17.5% of people during their lifetime, while the prevalence of male factor infertility is about 7%. Among numerous other causes, the prevalence of male genital tract infections reportedly ranges between 10% and 35%. Leukocytospermia is found in 30% of infertile men and up to 20% in fertile men. Bacterial infections cause an inflammatory response attracting leukocytes, which produce reactive oxygen species (ROS) and release cytokines, both of which can cause damage to sperm, rendering them dysfunctional. Although leukocytospermia and bacteriospermia are both clinical conditions that can negatively affect male fertility, there is still debate about their impact on assisted reproduction outcomes and management. According to World Health Organization (WHO) guidelines, leukocytes should be determined by means of the Endtz test or with monoclonal antibodies against CD15, CD68 or CD22. The cut-off value proposed by the WHO is 1 × 106 peroxidase-positive cells/mL. For bacteria, Gram staining and semen culture are regarded as the “gold standard”, while modern techniques such as PCR and next-generation sequencing (NGS) are allowing clinicians to detect a wider range of pathogens. Whereas the WHO manual does not specify a specific value as a cut-off for bacterial contamination, several studies consider semen samples with more than 103 colony-forming units (cfu)/mL as bacteriospermic. The pathogenic mechanisms leading to sperm dysfunction include direct interaction of bacteria with the male germ cells, bacterial release of spermatotoxic substances, induction of pro-inflammatory cytokines and ROS, all of which lead to oxidative stress. Clinically, bacterial infections, including “silent” infections, are treatable, with antibiotics being the treatment of choice. Yet, non-steroidal antiphlogistics or antioxidants should also be considered to alleviate inflammatory lesions and improve semen quality. In an assisted reproduction set up, sperm separation techniques significantly reduce the bacterial load in the semen. Nonetheless, contamination of the semen sample with skin commensals should be prevented by applying relevant hygiene techniques. In patients where leukocytospermia is detected, the causes (e.g. infection, inflammation, varicocele, smoking, etc.) of the leukocyte infiltration have to be identified and addressed with antibiotics, anti-inflammatories or antioxidants in cases where high oxidative stress levels are detected. However, no specific strategy is available for the management of leukocytospermia. Therefore, the relationship between bacteriospermia and leukocytospermia as well as their specific impact on functional sperm parameters and reproductive outcome variables such as fertilization or clinical pregnancy must be further investigated. The aim of this narrative review is to provide an update on the current knowledge on leukocytospermia and bacteriospermia and their impact on male fertility.

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Effects of leukocytospermia on the outcomes of assisted reproductive technology

Cited by 6 publications

References 37 publications

Leukocytospermia does not negatively impact outcomes in in vitro fertilization cycles with intracytoplasmic sperm injection and preimplantation genetic testing for aneuploidy: findings from 5435 cycles

Leukocytospermia does not negatively impact outcomes in in vitro fertilization cycles with intracytoplasmic sperm injection and preimplantation genetic testing for aneuploidy: findings from 5435 cycles

Male Infertility Coexists with Decreased Sperm Genomic Integrity and Oxidative Stress in Semen Irrespective of Leukocytospermia

Leukocytospermia and/or Bacteriospermia: Impact on Male Infertility

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