Predictive value of polymorphonuclear granulocytes in relation to growth of microorganisms in semen

Objective: Leukocytes, predominantly neutrophils, are frequently present in seminal plasma. An increased number of neutrophils (pyospermia) may indicate subclinical urogenital and/or male accessory gland infection. The aim of this study is to determine if the presence of neutrophils correlates with growth of specific type of microorganism(s). Design: A retrospective analysis of semen analysis results from 1999 to 2001 was conducted by the Andrology Laboratory at a large university based IVF program. The study sample comprised of 272 semen samples collected for routine analysis or intrauterine insemination procedure(s). The following specimens were excluded: collection problems, collection off site, and method of collection other than masturbation. Collection guidelines and semen analysis procedures followed WHO (1999) criteria with an acridine orange stain for neutrophils. Measurements were assessed by four andrologists with an intra and inter technician variations 10%. Materials/Methods: Enumeration of neutrophils was performed using two methodologies: peroxidase or acridine orange stain. Similar results were obtained with both procedures. Bacterial cultures were processed by a commercial laboratory (Quest Lab) that used standard culture techniques. Results: The current diagnosis of pyospermia is based upon a threshold of 1 X 106/cc (WHO, 1999). Nonetheless, of these patients with no definable bacteria on culture, 80% were pyospermic. Similarly, of these patients with a positive bacterial culture, 29% had semen PMN levels of 1M/cc. Of the positive cultures, the predominant microorganisms were Staph. epidermidis, Staph. haemolyticus, E. Coli, E. faecalis, a small percentage included Group B Streptococcus. Mean motility did not appear to be influenced by PMN or bacterial status: 52 and 51% for negative bacteria ( and 1M/cc PMNs) and 52 and 50% positive bacteria ( and 1M/cc PMNs) respectively.