Identification and treatment of leukocytospermia in couples with unexplained infertility.
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.
Branigan
E F
EF
Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle 98195, USA.
Spadoni
L R
LR
Muller
C H
CH
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
D000900:Anti-Bacterial Agents; D004318:Doxycycline