Chen L, Yu SL, Rajesh H
Correspondence: Dr Lihang Chen, lihang_chen@126.com
ABSTRACT
Introduction This study aims to evaluate whether an increased polymorphonuclear leucocyte (PMN) count in semen is a good predictor of male genital tract infection, which is detected by semen culture.
Methods A retrospective cross-sectional study examining the semen of 388 men was conducted at the in vitro fertilisation centre of a tertiary hospital. We compared the culture results of 109 men with increased semen PMN count against those of 279 men with normal semen PMN count.
Results There was no significant difference in the percentage of positive cultures between men with increased PMN count in their semen and those without PMN count elevation (original sensitivity 20.8%, specificity 70.3%; p = 0.1289). The overall percentage of positive semen cultures among all 388 patients was 18.6%.
Conclusion Based on the positive cultures of significant organisms in the semen of our cohort, an increased semen PMN count is not a good predictor of genital tract infection in men.
Keywords: bacteriospermia, infertility, male genital tract infection, polymorphonuclear leucocytes, sperm analysis
Singapore Med J 2013; 54(6): 328-331; http://dx.doi.org/10.11622/smedj.2013126
REFERENCES
1. Cooper TG, Aitken J, Auger J, et al, eds. WHO laboratory manual for the examination and processing of human semen. 5th ed. Switzerland: World Health Organization, 2010. | ||||
2. Bezold G, Politch JA, Kiviat NB, et al. Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia. Fertil Steril 2007; 87:1087-97. http://dx.doi.org/10.1016/j.fertnstert.2006.08.109 |
||||
3. Cumming JA, Carrell DT. Utility of reflexive semen cultures for detecting bacterial infections in patients with infertility and leukocytospermia. Fertil Steril 2009; 91 (4 Suppl):1486-8. http://dx.doi.org/10.1016/j.fertnstert.2008.07.1756 |
||||
4. Lackner JE, Herwig R, Schmidbauer J, et al. Correlation of leukocytospermia with clinical infection and the positive effect of antiinflammatory treatment on semen quality. Fertil Steril 2006; 86:601-5. http://dx.doi.org/10.1016/j.fertnstert.2006.01.032 |
||||
5. Cottell E, Harrison RF, McCaffrey M, et al. Are seminal fluid microorganisms of significance or merely contaminants? Fertil Steril 2000; 74:465-70. http://dx.doi.org/10.1016/S0015-0282(00)00709-3 |
||||
6. Lackner J, Schatzl G, Horvath S, Kratzik C, Marberger M. Value of counting white blood cells (WBC) in semen samples to predict the presence of bacteria. Eur Urol 2006; 49:148-52; discussion 152-3. http://dx.doi.org/10.1016/j.eururo.2005.08.017 |
||||
7. Gdoura R, Kchaou W, Znazen A, et al. Screening for bacterial pathogens in semen samples from infertile men with and without leukocytospermia. Andrologia 2008; 40:209-18. http://dx.doi.org/10.1111/j.1439-0272.2008.00845.x |
||||
8. Aitken RJ, Baker HW, Barratt CL, et al, eds. WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 4th ed. Cambridge, United Kingdom: World Health Organization, 1999. | ||||
9. Schaeffer AJ, Knauss JS, Landis JR, et al. Leukocyte and bacterial counts do not correlate with severity of symptoms in men with chronic prostatitis: the National Institutes of Health Chronic Prostatitis Cohort Study. J Urol 2002; 168:1048-53. http://dx.doi.org/10.1016/S0022-5347(05)64572-7 |
||||
10. Berger RE, Karp LE, Williamson RA, et al. The relationship of pyospermia and seminal fluid bacteriology to sperm function as reflected in the sperm penetration assay. Fertil Steril 1982; 37:557-64. | ||||
11. Rodin DM, Larone D, Goldstein M. Relationship between semen cultures, leukospermia, and semen analysis in men undergoing fertility evaluation. Fertil Steril 2003; 79 Suppl 3:1555-8. http://dx.doi.org/10.1016/S0015-0282(03)00340-6 |
||||
12. Eggert-Kruse W, Probst S, Rohr G, Aufenanger J, Runnebaum B. Screening for subclinical inflammation in ejaculates. Fertil Steril 1995; 64:1012-22. | ||||
13. Eggert-Kruse W, Zimmermann K, Geissler W, et al. Clinical relevance of polymorphonuclear (PMN-) elastase determination in semen and serum during infertility investigation. Int J Androl 2009; 32:317-29. http://dx.doi.org/10.1111/j.1365-2605.2007.00852.x |
||||
14. Cardoso EM, Santoianni JE, De Paulis AN, et al. Improvement of semen quality in infected asymptomatic infertile male after bacteriological cure. Medicina (B Aires) 1998; 58:160-4. | ||||
15. Virecoulon F, Wallet F, Fruchart-Flamenbaum A, et al. Bacterial flora of the low male genital tract in patients consulting for infertility. Andrologia 2005; 37:160-5. http://dx.doi.org/10.1111/j.1439-0272.2005.00673.x |
||||
16. Kiessling AA, Lamparelli N, Yin HZ, Seibel MM, Eyre RC. Semen leukocytes: friends or foes? Fertil Steril 1995; 64:196-8. | ||||
17. Willén M, Holst E, Myhre EB, Olsson AM. The bacterial flora of the genitourinary tract in healthy fertile men. Scand J Urol Nephrol 1996; 30:387-93. http://dx.doi.org/10.3109/00365599609181315 |
||||
18. Zheng J, Yu SY, Jia DS, et al. [Ureaplasma urealyticum infection in the genital tract reduces seminal quality in infertile men]. Zhonghua Nan Ke Xue 2008; 14:507-12. Chinese. | ||||
19. Reinhardt A, Haidl G, Schill WB. Granulocyte elastase indicates silent male genital tract inflammation and appropriate anti-inflammatory treatment. Andrologia 1997; 29:187-92. http://dx.doi.org/10.1111/j.1439-0272.1997.tb00315.x |
||||
20. Kopa Z, Wenzel J, Papp GK, Haidl G. Role of granulocyte elastase and interleukin-6 in the diagnosis of male genital tract inflammation. Andrologia 2005; 37:188-94. http://dx.doi.org/10.1111/j.1439-0272.2005.00676.x |