2185 THE INCIDENCE AND EFFECT OF BACTERIOSPERMIA AND ELEVATED SEMINAL WHITE BLOOD CELLS ON SEMEN PARAMETERS

Abstract

You have accessJournal of UrologyInfertility: Evaluation1 Apr 20112185 THE INCIDENCE AND EFFECT OF BACTERIOSPERMIA AND ELEVATED SEMINAL WHITE BLOOD CELLS ON SEMEN PARAMETERS Trustin Domes, Kirk Lo, Ethan Grober, Brendan Mullen, Tony Mazzulli, and Keith Jarvi Trustin DomesTrustin Domes Toronto, Canada More articles by this author , Kirk LoKirk Lo Toronto, Canada More articles by this author , Ethan GroberEthan Grober Toronto, Canada More articles by this author , Brendan MullenBrendan Mullen Toronto, Canada More articles by this author , Tony MazzulliTony Mazzulli Toronto, Canada More articles by this author , and Keith JarviKeith Jarvi Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2423AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In the infertile male, the effect of bacteriospermia and elevated seminal white blood cells (ESWBC) on semen parameters remains controversial. Despite this, the majority of men with bacteriospermia are treated with antibiotics. The objectives of this study are to determine the incidence of ESWBC and bacteriospermia (specific bacterial isolates) in a large non-azoospermic male infertility population, correlate these results with semen parameters and to determine which bacterial isolates negatively affect semen parameters preferentially. METHODS Non-azoospermic male patients attending a tertiary-level infertility clinic over nine years (2001–2010) that had a semen analysis and semen culture performed concurrently were included in the study. ESWBC was defined as ≥ 1 WBC in semen per 100 sperm. The prospectively collected microbiology results were merged with a prospectively collected andrology database for analysis. RESULTS During the study period, 8158 semen analysis and concurrent semen culture pairs were identified in 5088 patients with a median age of 37 years. The rate of bacteriospermia was 15%, incorporating 22 bacterial species. The four most common species accounted for 90% of bacterial isolates: E. fecalis (56%), E. coli (16%), Group B Streptococcus (13%) and S. aureus (5%). The rate of ESWBC was 19% and there was no correlation between bacteriospermia and ESWBC (18% ESWBC associated with bacteriospermia versus 19% ESWBC not associated with bacteriospermia, p= 0.383). There were statistically significant differences in sperm motility (24.5 vs. 25.5%, p=0.045) and DNA fragmentation index (DFI) (24.9 vs. 22.6%, p=0.024) in the bacteriospermia versus no bacteriospermia group. ESWBC alone was associated with more profound deterioration in semen parameters, including sperm concentration (20.6 vs. 55.9 x 106/cc, p<0.001), motility (21.5 vs. 26.8%, p<0.001), normal morphology (12.2 vs. 17.4%, p<0.001) and DFI (26.7 vs. 22.2%, p<0.001) with no additional deterioration identified with bacteriospermia and ESWBC together. No specific bacterial isolate preferentially deteriorated any semen parameter more than the other. CONCLUSIONS This large series demonstrates that both bacteriospermia and ESWBC are prevalent in men with infertility, however bacteriospermia was not statistically associated with ESWBC. While both are associated with diminished semen parameters, ESWBC is associated with the most profound deterioration in semen parameters. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e876 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Trustin Domes Toronto, Canada More articles by this author Kirk Lo Toronto, Canada More articles by this author Ethan Grober Toronto, Canada More articles by this author Brendan Mullen Toronto, Canada More articles by this author Tony Mazzulli Toronto, Canada More articles by this author Keith Jarvi Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...