Abstract
Introduction: Pyospermia is often detected in semen, especially when investigating for male infertility. Pyospermia, in a significantly large number is often correlated with inferior sperm parameters and reduced fertility. Pyospermia may be a factor of a fundamental genitourinary infection. This study assessed the relationship between pus cells and semen parameters in infertile Nigerian males. Subjects and Methods: A cross-sectional descriptive study was carried out at Nordica Fertility Center, Lagos, Nigeria, from 2004 to 2009. A total of 907 subjects were analyzed. Subjects ages (years) were categorized into ≤30, 30.1 - 35, 35.1 - 40, 40.1 - 45, 45.1 - 50 and >50, BMI into x2 = 0.05, P-value = 0.51, OR = 1.82, 95% CI: 0.30, 11.02). Mean progressive motility (%) was significantly reduced (t = 1.95, P-value = 0.03) among patients with ≥3/hpf pyospermia (33.75 ± 19.23) compared to those with 1 - 2/hpf pyospermia (38.58 ± 21.63). Patients with sperm oval head ≤ 30% had significantly higher pyospermia (t = 2.22, P-value = 0.013) than those with sperm oval head of >30%. Conclusion: Elevated pus cell counts were observed among obese azoospermic men, those with reduced sperm progressive motility and those with lower count of sperms with oval head morphology. Clinicians should consider pyospermia relative to body mass index and mean progressive motility in their management of male infertility.
Highlights
Pyospermia is often detected in semen, especially when investigating for male infertility
Askienazy-Elbhar [16] reported that infections or inflammation of the urethra and prostatitis are the principal causes of pyospermia, which are mostly asymptomatic, and which are detected after performing seminal fluid analysis as part of male infertility work-up or when a man is screened before becoming a sperm donor
Various studies have revealed that sexual abstinence can have an influence, as the more time sperms remain in the epididymis, the greater the number of macrophages and granulocytes that will be attracted by older sperm, which can cause an elevated level of leukocytes in the ejaculate
Summary
Pyospermia is often detected in semen, especially when investigating for male infertility. Enwuru et al, [20] reported that normozoospermic males with pyospermia had lower sperm concentration compared with those without contamination, while Onemu and Ibeh [21] concluded that pathogenic pyospermia, consequent upon breach in the integrity of the blood-testes barrier, may provide early warning signals of impairment of male fertility These studies looked at pyospermia mainly from icrobiologyic perspective and did not fully relate pyospermia to age group, body mass index, progressive motility, and normal sperm morphology consisting of sperms with oval heads. The objective of this study, is to report the association of pyospermia with different age group categories, different BMI categories, different motility categories and different concentrations of normal sperm cell morphology among infertile men presenting for assisted reproduction technology in Nigeria
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