PROSPECTIVE-STUDY OF LEUKOCYTES AND LEUKOCYTE SUBPOPULATIONS IN SEMENSUGGESTS THEY ARE NOT A CAUSE OF MALE-INFERTILITY

Objective: To determine the effects of leukocytes in semen on sperm qu ality and the ability to achieve conception. Design: A prospective ana lysis of 512 couples attending a regional infertility clinic. Leukocyt e subsets were quantified using a monoclonal antibody-based staining p rocedure. In addition to basic seminal parameters (density, motility, morphology, and antisperm antibodies), reactive oxygen species and imm ature germ cells were also quantified in the semen of each patient. Th e presence or absence of a treatment-independent conception was determ ined 22 months after the start of the study. Semen parameters were the n related to the ability to conceive. Setting: University-based center for reproductive medicine. Participants: Success or failure to concei ve was recorded from 512 couples. Couples were then selected to minimi ze the influence of any pathology of the female on outcome. A final st udy group of 229 couples, in which the women had regular menstrual cyc les, ovulatory midluteal serum P levels of >18 nmol/L, and patent fall opian tubes was finally selected for analysis. Main Outcome Measure: P regnancy. Results: Leukocyte concentration (total or individual subset s) was not associated with either reduced semen quality or conception rates. Similarly, neither reactive oxygen species or antisperm antibod y (immunobead) concentration had any bearing on the outcome. Of all se men parameters measured, only the level of immature germ cells was fou nd to be negatively associated with the rate of conception. Conclusion : Measurement of seminal leukocytes in routine semen analysis appears to be of little prognostic value with regard to male fertilizing poten tial. As reactive oxygen species and antisperm measurement were of sim ilar predictive value, the term ''immunologic male infertility'' shoul d be redefined.