Relevance of Leukocytospermia and Semen Culture and Its True Place in Diagnosing and Treating Male Infertility

Rakesh Sharma, Sajal Gupta, Ashok Agarwal, Ralf Henkel, Renata Finelli, Neel Parekh, Ramadan Saleh, Mohamed Arafa, Edmund Ko, Armand Zini, Nicholas Tadros, Rupin Shah, Rafael F. Ambar, Haitham Elbardisi, Pallav Sengupta, Marlon Martinez, Florence Boitrelle, Mara Simopoulou, Paraskevi Vogiatzi, Jaime GosalvezParviz Kavoussi, Hussein Kandil, Ayad Palani, Marcelo Rodriguez Peña, Osvaldo Rajmil, Gian Maria Busetto, Christina Anagnostopoulou, Sava Micic, Marco G. Alves, Lucia Rocco, Taymour Mostafa, Juan G. Alvarez, Sunil Jindal, Hassan N. Sallam, Israel Maldonado Rosas, Sheena E.M. Lewis, Sami AlSaid, Mesut Altan, Hyun Jun Park, Jonathan Ramsay, Sijo Parekattil, Marjan Sabbaghian, Kelton Tremellen, Kareim Khalafalla, Damayanthi Durairajanayagam, Giovanni M. Colpi

Research output: Contribution to journalReview articlepeer-review

12 Citations (Scopus)


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.

Original languageEnglish
Article numbere32
Pages (from-to)191-207
Number of pages17
JournalWorld Journal of Men's Health
Issue number2
Publication statusPublished - 15 Jun 2021


  • Culture
  • Endtz
  • Infections
  • Inflammation
  • Leukocytes
  • Spermatozoa


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