title: Identification and treatment of leukocytospermia in couples with unexplained infertility.
abstract: OBJECTIVE
  To evaluate whether identifying men with leukocytospermia in couples with unexplained infertility and treating them with antibiotics improves pregnancy rates.
  
  
  METHODS
  A prospective, cohort study of men with and without leukocytospermia was identified on a smear of semen using Bryan-Leishman stain. Cumulative six-month pregnancy rates were determined for members of the leukocytospermic group who responded to treatment with resolution of their leukocytospermia on a semen smear, those who failed to respond to treatment, those not treated and those without leukocytospermia.
  
  
  RESULTS
  Thirty-six of 53 men with leukocytospermia responded to antibiotic treatment, and 19 women in these 36 couples (53%) became pregnant within the six-month follow-up period. Only 7 of 17 (6%) of those who failed to respond to treatment had their partner become pregnant (P < .001). Partners of men with leukocytospermia and no treatment had a 6% pregnancy rate, and the women in 13% (5/42) of couples without leukocytospermia became pregnant (P < .001).
  
  
  CONCLUSIONS
  Leukocytospermia exists in a significant number of males with unexplained infertility and normal semen analyses. Identifying and successfully treating such men results in a significant improvement in pregnancy rates. These men may be a subgroup with male infertility that can be identified and treated.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle 98195, USA.
authors.forename: E F
authors.initials: EF
authors.lastname: Branigan
authors.forename: L R
authors.initials: LR
authors.lastname: Spadoni
authors.forename: C H
authors.initials: CH
authors.lastname: Muller
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015331:Cohort Studies; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D007964:Leukocytosis / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012661:Semen / Q000166:cytology* / Q000502:physiology; D013076:Sperm Count; D013081:Sperm Motility / Q000502:physiology; D013084:Sperm-Ovum Interactions / Q000502:physiology; D013094:Spermatozoa / Q000473:pathology* / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline