Relevance of Leukocytospermia and Semen Culture and Its True Place in Diagnosing and Treating Male Infertility

Sharma, Rakesh; Gupta, Sajal; Agarwal, Ashok; Henkel, Ralf; Finelli, Renata; Parekh, Neel; Saleh, Ramadan; Arafa, Mohamed; Ko, Edmund; Zini, Armand; Tadros, Nicholas; Shah, Rupin; Ambar, Rafael F.; Elbardisi, Haitham; Sengupta, Pallav; Martinez, Marlon; Boitrelle, Florence; Simopoulou, Mara; Vogiatzi, Paraskevi; Gosalvez, Jaime; Kavoussi, Parviz; Kandil, Hussein; Palani, Ayad; Peña, Marcelo Rodriguez; Rajmil, Osvaldo; Busetto, Gian Maria; Anagnostopoulou, Christina; Micic, Sava; Alves, Marco G.; Rocco, Lucia; Mostafa, Taymour; Alvarez, Juan G.; Jindal, Sunil; Sallam, Hassan N.; Rosas, Israel Maldonado; Lewis, Sheena E.M.; AlSaid, Sami; Altan, Mesut; Park, Hyun Jun; Ramsay, Jonathan; Parekattil, Sijo; Sabbaghian, Marjan; Tremellen, Kelton; Khalafalla, Kareim; Durairajanayagam, Damayanthi; Colpi, Giovanni M.

World J Mens Health. 2022 Apr;40(2):191-207. 10.5534/wjmh.210063.

Relevance of Leukocytospermia and Semen Culture and Its True Place in Diagnosing and Treating Male Infertility

Sharma R ¹
Gupta S ¹
Agarwal A ¹
Henkel R ^1,2,3
Finelli R ¹
Parekh N ⁴
Saleh R ⁵
Arafa M ^1,6,12
Ko E ⁷
Zini A ⁸
Tadros N ⁹
Shah R ¹⁰
Ambar RF ¹¹
Elbardisi H ^6,12
Sengupta P ¹³
Martinez M ¹⁴
Boitrelle F ^15,16
Simopoulou M ¹⁷
Vogiatzi P ¹⁸
Gosalvez J ¹⁹
Kavoussi P ²⁰
Kandil H ²¹
Palani A ²²
Peña MR ²³
Rajmil O ²⁴
Busetto GM ²⁵
Anagnostopoulou C ²⁶
Micic S ²⁷
Alves MG ²⁸
Rocco L ²⁹
Mostafa T ³⁰
Alvarez JG ^31,32
Jindal S ³³
Sallam HN ³⁴
Rosas IM ³⁵
Lewis SE ³⁶
AlSaid S ⁶
Altan M ³⁷
Park HJ ^38,39
Ramsay J ⁴⁰
Parekattil S ⁴¹
Sabbaghian M ⁴²
Tremellen K ⁴³
Khalafalla K ⁶
Durairajanayagam D ⁴⁴
Colpi GM ⁴⁵

Affiliations

¹American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
²Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
³Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa.
⁴Department of Urology, Cleveland Clinic, Cleveland, OH, USA.
⁵Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt.
⁶Department of Urology, Hamad Medical Corporation, Doha, Qatar.
⁷Department of Urology, Loma Linda University Health, Loma Linda, CA, USA.
⁸Department of Surgery, McGill University, Montreal, Canada.
⁹Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA.
¹⁰Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India.
¹¹Department of Urology, Centro Universitario em Saude do ABC/Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil.
¹²Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar.
¹³Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor, Malaysia.
¹⁴Section of Urology, University of Santo Tomas Hospital, Manila, Philippines.
¹⁵Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France.
¹⁶Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France.
¹⁷Department of Physiology, School of Medicine, National & Kapodistrian University of Athens, Maroussi, Athens, Greece.
¹⁸Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Greece.
¹⁹Departamento de Biología, Universidad Autónoma de Madrid, Madrid, Spain.
²⁰Austin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
²¹Fakih IVF Fertility Center, Abu Dhabi, UAE.
²²Department of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq.
²³Departamento Docencia e Investigación, Hospital Militar Campo de Mayo, Universidad Barcelo, Buenos Aires, Argentina.
²⁴Clinical and training Centre of the European Academy of Andrology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
²⁵Department of Urology and Renal Transplantation, University of Foggia Policlinico Riuniti of Foggia, Foggia, Italy.
²⁶IVF Clinic “Akeso-Embryo ART”, Athens, Greece.
²⁷Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia.
²⁸Department of Anatomy & Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal.
²⁹Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania Luigi Vanvitelli, Caserta, Italy.
³⁰Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt.
³¹Centro ANDROGEN, La Coruña, Spain.
³²Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA, USA.
³³Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India.
³⁴Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt.
³⁵Centerf Technological Innovation, and Reproductive Medicine (CITMER), Mexico City, Mexico.
³⁶Examenlab Ltd., Weavers Court Business Park, Linfield Road, Belfast, Northern Ireland, UK.
³⁷Department of Urology, Haceppete University, Ankara, Turkey.
³⁸Department of Urology, Pusan National University School of Medicine, Busan, Korea.
³⁹Medical Research Institute of Pusan National University Hospital, Busan, Korea.
⁴⁰Department of Andrology, Hammersmith Hospital, London, UK.
⁴¹Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA.
⁴²Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
⁴³Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia.
⁴⁴Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia.
⁴⁵Andrology and IVF Unit, Procrea Institute, Lugano, Switzerland.

KMID: 2527318
DOI: http://doi.org/10.5534/wjmh.210063

Abstract

The current WHO 2010 manual for human semen analysis defines leukocytospermia as the presence of peroxidase-positive leukocytes at a concentration >1×10 6 /mL of semen. Granular leukocytes when activated are capable of generating high levels of reactive oxygen species in semen resulting in oxidative stress. Oxidative stress has been correlated with poor sperm quality, increased level of sperm DNA fragmentation and low fertility potential. The presence of leukocytes and pathogens in the semen may be a sign of infection and/or localized inflammatory response in the male genital tract and the accessory glands. Common uro-pathogens including Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae, Mycoplasma hominis, and Escherichia coli can cause epididymitis, epididymo-orchitis, or prostatitis. The relationship between leukocytospermia and infection is unclear. Therefore, we describe the pathogens responsible for male genital tract infections and their association with leukocytospermia. The review also examines the diagnostic tests available to identify seminal leukocytes. The role of leukocytospermia in male infertility and its management is also discussed.

Keyword

Culture; Endtz; Infections; Inflammation; Leukocytes; Spermatozoa

Relevance of Leukocytospermia and Semen Culture and Its True Place in Diagnosing and Treating Male Infertility

Abstract

Keyword

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