NONSPERM CELLS IN HUMAN SEMEN - WITH SPECIAL REFERENCE TO SEMINAL LEUKOCYTES AND THEIR POSSIBLE INFLUENCE ON FERTILITY

Nonspermatozoal cells (NSC) in semen, including immature germ cells, l eukocytes (WBC) and epithelial cells, are normally found in a concentr ation less than 15% of the sperm concentration. Cytological staining m ethods and immunoenzymatic assays for characterization of seminal WBC and methods for detection of various enzymes from WBC are evaluated. C riteria for abnormally high levels of WBC in semen, caused by exogenic factors (e.g., infection) and possibly by endogenic factors (e.g., ab normal sperm), are discussed. Leukocytospermia is associated with redu ced in vitro fertilization rate, and experimentally-measured sperm fun ctions (e.g., motility) are inhibited by high concentrations of certai n WBC products (e.g., reactive oxygen species and interferon-gamma). A t the present stage, the following procedures could be used to evaluat e WBC in ejaculates from infertile patients: (1) count the number of N SC using a hemocytometer. (2) Determine the number of WBC in percentag e of NSC in smears using the Papanicolaou staining technique, or an im muno-enzymatic assay using monoclonal antibodies to the different kind s of WBC. (3) if abnormally high levels of WBC (according to the WHO c riteria or based on a percentile determined from examination of normal , fertile men) is detected, a second ejaculate should be examined 3 mo nths later. (4) Persistent leukocytospermia should indicate physical a nd microbiological examinations, after which antibiotic treatment may be indicated.