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Sharma R, Gupta S, Agarwal A, Henkel R, Finelli R, Parekh N, Saleh R, Arafa M, Ko E, Zini A, Tadros N, Shah R, Ambar RF, Elbardisi H, Sengupta P, Martinez M, Boitrelle F, Simopoulou M, Vogiatzi P, Gosalvez J, Kavoussi P, Kandil H, Palani A, Rodriguez Peña M, Rajmil O, Busetto GM, Anagnostopoulou C, Micic S, Alves MG, Rocco L, Mostafa T, Alvarez JG, Jindal S, Sallam HN, Maldonado Rosas I, Lewis SEM, AlSaid S, Altan M, Park HJ, Ramsay J, Parekattil S, Sabbaghian M, Tremellen K, Khalafalla K, Durairajanayagam D, Colpi GM. Relevance of Leukocytospermia and Semen Culture and Its True Place in Diagnosing and Treating Male Infertility. World J Mens Health 2022; 40:191-207. [PMID: 34169683 PMCID: PMC8987138 DOI: 10.5534/wjmh.210063] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/17/2021] [Accepted: 04/21/2021] [Indexed: 02/05/2023] Open
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.
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Affiliation(s)
- Rakesh Sharma
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Sajal Gupta
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Neel Parekh
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed Arafa
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Armand Zini
- Department of Surgery, McGill University, Montreal, Canada
| | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Rafael F Ambar
- Department of Urology, Centro Universitario em Saude do ABC/Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Pallav Sengupta
- Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor, Malaysia
| | - Marlon Martinez
- Section of Urology, University of Santo Tomas Hospital, Manila, Philippines
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Mara Simopoulou
- Department of Physiology, School of Medicine, National & Kapodistrian University of Athens, Maroussi, Athens, Greece
| | - Paraskevi Vogiatzi
- Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Greece
| | - Jaime Gosalvez
- Departamento de Biología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Parviz Kavoussi
- Austin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | | | - Ayad Palani
- Department of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq
| | - Marcelo Rodriguez Peña
- Departamento Docencia e Investigación, Hospital Militar Campo de Mayo, Universidad Barcelo, Buenos Aires, Argentina
| | - Osvaldo Rajmil
- Clinical and training Centre of the European Academy of Andrology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia Policlinico Riuniti of Foggia, Foggia, Italy
| | | | - Sava Micic
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Marco G Alves
- Department of Anatomy & Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Lucia Rocco
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Taymour Mostafa
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Juan G Alvarez
- Centro ANDROGEN, La Coruña, Spain
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA, USA
| | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Hassan N Sallam
- Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Israel Maldonado Rosas
- Centerf Technological Innovation, and Reproductive Medicine (CITMER), Mexico City, Mexico
| | - Sheena E M Lewis
- Examenlab Ltd., Weavers Court Business Park, Linfield Road, Belfast, Northern Ireland, UK
| | - Sami AlSaid
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Mesut Altan
- Department of Urology, Haceppete University, Ankara, Turkey
| | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | | | - Sijo Parekattil
- Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia
| | | | - Damayanthi Durairajanayagam
- Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
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