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

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

Affiliations 

  • 1 American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
  • 2 American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA. agarwaa@ccf.org
  • 3 Department of Urology, Cleveland Clinic, Cleveland, OH, USA
  • 4 Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
  • 5 Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
  • 6 Department of Surgery, McGill University, Montreal, Canada
  • 7 Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
  • 8 Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
  • 9 Department of Urology, Centro Universitario em Saude do ABC/Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
  • 10 Department of Urology, Hamad Medical Corporation, Doha, Qatar
  • 11 Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor, Malaysia
  • 12 Section of Urology, University of Santo Tomas Hospital, Manila, Philippines
  • 13 Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
  • 14 Department of Physiology, School of Medicine, National & Kapodistrian University of Athens, Maroussi, Athens, Greece
  • 15 Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Greece
  • 16 Departamento de Biología, Universidad Autónoma de Madrid, Madrid, Spain
  • 17 Austin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
  • 18 Fakih IVF Fertility Center, Abu Dhabi, UAE
  • 19 Department of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq
  • 20 Departamento Docencia e Investigación, Hospital Militar Campo de Mayo, Universidad Barcelo, Buenos Aires, Argentina
  • 21 Clinical and training Centre of the European Academy of Andrology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
  • 22 Department of Urology and Renal Transplantation, University of Foggia Policlinico Riuniti of Foggia, Foggia, Italy
  • 23 IVF Clinic "Akeso-Embryo ART", Athens, Greece
  • 24 Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
  • 25 Department of Anatomy & Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
  • 26 Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania Luigi Vanvitelli, Caserta, Italy
  • 27 Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
  • 28 Centro ANDROGEN, La Coruña, Spain
  • 29 Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
  • 30 Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt
  • 31 Centerf Technological Innovation, and Reproductive Medicine (CITMER), Mexico City, Mexico
  • 32 Examenlab Ltd., Weavers Court Business Park, Linfield Road, Belfast, Northern Ireland, UK
  • 33 Department of Urology, Haceppete University, Ankara, Turkey
  • 34 Department of Urology, Pusan National University School of Medicine, Busan, Korea
  • 35 Department of Andrology, Hammersmith Hospital, London, UK
  • 36 Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA
  • 37 Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
  • 38 Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia
  • 39 Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
  • 40 Andrology and IVF Unit, Procrea Institute, Lugano, Switzerland
World J Mens Health, 2022 Apr;40(2):191-207.
PMID: 34169683 DOI: 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 >1×106/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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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