The limit of leucocytospermia from the microbiological viewpoint

Abstract

The aim of the study was to find out the correlation between white blood cell (WBC) counts in semen and quantitative composition of seminal microflora, and to establish the minimum WBC count associated with significant bacteriospermia. The research included 159 men with different WBC counts in their semen, 84 of them with chronic prostatitis/chronic pelvic pain syndrome. Semen samples were cultivated quantitatively for detecting anaerobic, microaerophilic and aerobic bacteria. Bryan-Leishman stained slides were used for detecting WBC in semen. Seminal fluid was colonized by eight different microorganisms, and the total count of microorganisms in semen ranged from 102 to 107 CFU ml-1. A high frequency of anaerobic microorganisms was found. A positive correlation was observed between the WBC count and the number of different microorganisms, and also between the WBC count and the total count of microorganisms in semen sample. The receiver operating characteristic curve analysis demonstrated that the WHO-defined WBC cut-off point (1 x 106 WBC ml-1) has very low sensitivity for discriminating between patients with and without significant bacteriospermia, as a more optimal sensitivity/specificity ratio appears at 0.2 x 106 WBC ml-1 of semen. The quantitative microbiological finding of semen in the patients of National Institute of Health (NIH) categories IIIa and IV was very similar, i.e. a high number of different microorganisms and a high total count of microorganisms. In the control group (without leucocytospermia and prostatitis symptoms) both parameters were significantly lower.

Mechanisms of the harmful effects of bacterial semen infection on ejaculated human spermatozoa: potential inflammatory markers in semen

“…However, some authors have postulated the necessity to reevaluate this threshold [47][48][49][50]. According to the kinetics of the inflammatory process in the urogenital tract previously proposed by our group, leukocytes appear in semen as the addition to bacteriospermia at the second stage of the urogenital tract infection, and remain present in semen for some length of time following the elimination of the bacteria in the third stage (isolated leukocytospermia) [51].…”

The Role of Chlamydia trachomatis in Male Infertility

“…Most studies show no correlation between the presence of leukocytes and bacteria in semen [74][75][76]. However, Punab et al observed a positive correlation between the leukocyte count and the number of different bacteria detected in semen, and also between the leukocyte count and the total count of microorganisms in semen samples [77]. In fact, these authors along with Gdoura et al [78] demonstrated that the WHO-defined cut-off point (1x10 6 leukocytes per mL) has very low sensitivity for discriminating between patients with and without significant bacteriospermia, as a more optimal sensitivity/specificity ratio appears at 0.2x10 6 leukocytes per mL of semen.…”

Improving precision in the assessment of round cell numbers in human semen

“…Some have found this value too low [1], others too high [2,3], depending on the end-point examined (semen quality, In Vitro Fertilization [IVF] results, bacterial presence, sperm response to reactive oxygen species). Other values from 0.5 × 10 6 -1.0 × 10 6 polymorphs per mL or 1 × 10 6 -2 × 10 6 leukocytes per mL have been suggested [1].…”

“…Wolff et al [5] diluted semen 1 + 1 with reagent, which should present 50 cells (%SE 14%) in the central Neubauer grid, providing estimates of 1 280 000 to 720 000 cells per mL. Punab et al [3] assessed the leukocyte concentration by comparing their number per microscope field relative to those of spermatozoa and multiplying by the sperm concentration. As a total of 200 round cells was counted, which gives a %SE of 7%, a true value of 10 6 mL -1 could be assessed as 1 140 000 or 860 000 cells per mL, although the accuracy of the method of assessing sperm concentration was not given.…”