Mj. Tomlinson et al., PROSPECTIVE-STUDY OF LEUKOCYTES AND LEUKOCYTE SUBPOPULATIONS IN SEMENSUGGESTS THEY ARE NOT A CAUSE OF MALE-INFERTILITY, Fertility and sterility, 60(6), 1993, pp. 1069-1075
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.