What is leukocytospermia? It has been described as “an abnormal laboratory finding defined by the World Health Organisation as the presence of leukocytes in human ejaculate and reflects the presence of genital tract infection.” Leukocytes are blood cells made in the bone marrow and are found in the blood and lymph tissues. They form a part of the body’s immune system to fight infection and other diseases. In the context of male infertility testing, the presence of leukocytes can indicate underlying issues that may affect fertility.
In semen, leukocytes help create an inflammatory response which assists in eliminating harmful bacteria and resulting in death of immature or abnormal sperm by production of ROS (reactive oxygen species). Active leukocytes can result in producing 1000 times more ROS than that released by spermatozoa.
However, when the percentage is too high, leukocytospermia takes place which indicates infection or inflammation of the sex glands and male genital tract. This results in MAGI (male accessory gland infection) and MGTI (male genital tract infection). Both of these can negatively affect male reproductivity and male fertility – upto nearly 15%.
MAGI suggests inflammation/infection of the accessory glands like the prostate, seminal vesicles (pair of glands which open into the vas deferens and secrete many components of semen) and Cowper’s glands (located below the prostate gland and which add fluids to semen during ejaculation). Inflammation of the excurrent duct system (which include the epididymis – duct behind the testis which passes semen – vas deferens, urethra etc) and which are not part of the body structure are not included in MAGI.
MGTI, on the other hand, involves the entire male genital tract. Usually, when leukocytospermia is found in the semen with harmful bacteria, as well as inflammation in the male genital tract, the presence of MGTI is detected. This can lead to less sperm being produced, diminished sperm function and blockage of the seminal tract. Some studies have shown that MGTIs are one of the main causes of male infertility, along with idiopathic (unknown cause) infertility and varicocele.
Another factor of MGTI is that some of the infections are present without symptoms. This happens in nearly 50% of the men and it is usually higher in younger men who are sexually active. Unless detected, they may remain untreated and possibly lead to complications with fertility.
Leukocytospermia results in high levels of ROS (reactive oxygen species) in the semen, which generates oxidative stress. In turn, oxidative stress is related with low quality sperm, higher DNA fragmentation of sperm and less potential of fertility. Increased leukocytes and harmful bacteria in the semen may signify infection/inflammation in the accessory glands or male genital tract.
Leukocytospermia has been associated with cigarette smoking. Heavy smoking can activate leukocytes which result in high levels of ROS and oxidative stress. Ingredients in tobacco can cause inflammation which can lead to leukocytospermia in the fluid portion of the semen before and during ejaculation. It has also been found in men with spinal cord injuries, where high levels of leukocytes and ROS have been observed in their ejaculations.
Usually, leukocytospermia is treated with antibiotics and antioxidants. However, tests need to be conducted to find out if this inhibitor is present. Usually, if the WBC (white blood cell count) is high in semen, it is associated with male infertility. The Endtz test is carried out when a routine semen analysis shows a higher percentage of round cells (ie, WBC or immature sperm). Other tests to measure leukocytes are the Seminal granulocyte elastase test and Peroxidase test.
At Andrology Center, in addition to the basic semen analysis test, we carry out the more specific DFI (DNA fragmentation index) test, using one of the best methods – the SCSA (sperm chromatin structure assay). Our state-of-the-art equipment and excellent technology guarantee accurate results. We provide standardised reports which are clinically relevant. We are proud to be the only laboratory in India authorised to carry out the genuine SCSA® test.
With these results, it makes it easier for the fertility specialist to check on leukocytospermia and its effect on the patient. This, in turn, helps in diagnosing the problem and rendering the best treatment possible.
