Abstract
Round cells in seminal fluid are defined as either leucocytes or immature germ cells. Laboratories undertaking semen analysis often report these combined as a concentration, with no further review, comment or direction for clinician action or review. Although numerous publications discuss the possible clinical relevance of these cells (particularly leucocytes) in infertility, the methods employed to differentiate them are often beyond the scope of most diagnostic laboratories. This paper aims to support healthcare scientists in understanding the clinical significance of round cells and aid their identification, differentiation and interpretation. This will support the quality of care the patient receives and direct clinicians to further considerations that may be appropriate for their patient and should consequently reduce indiscriminate and unnecessary use of antibiotics.
Highlights
The first World Health Organisation (WHO) Laboratory manual for the examination of human semen and sperm-cervical mucus interaction was introduced in 1980 [1], and the sixth edition, entitled WHO laboratory manual for the examination and processing of human semen, (WHO 2021) was released in July 2021 [2]
Whilst most laboratories will align diagnostic semen analysis (DSA) with current WHO guidelines, DSA techniques and clinical treatment have barely progressed compared with the advancement in research surrounding cellular and molecular sperm function [3]
This paper aims to review the possible importance of recognising round cells, differentiating between cell types and to address this from both a laboratory and clinical perspective
Summary
The first World Health Organisation (WHO) Laboratory manual for the examination of human semen and sperm-cervical mucus interaction was introduced in 1980 [1], and the sixth edition, entitled WHO laboratory manual for the examination and processing of human semen, (WHO 2021) was released in July 2021 [2]. Whilst most laboratories will align diagnostic semen analysis (DSA) with current WHO guidelines, DSA techniques and clinical treatment have barely progressed compared with the advancement in research surrounding cellular and molecular sperm function [3]. The estimation of round cell concentration is included in some basic semen analysis procedures. Leucocytes and immature germ cells present in semen are collectively defined as “round cells” [2]. Germ cells are defined as the precursors of gametes, for example, spermatocytes in spermatogenesis [2]. WHO 2021 details methods for round cell concentration estimation, and further specific techniques for the confirmation of these cell types. These include immunocytochemistry using peroxidase activity for leucocyte recognition [2]. The manual acknowledges the difficulties in interpreting the clinical significance of the identification of leucocytes in semen
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