THE CORRELATION BETWEEN ROUND CELLS AND WHITE BLOOD-CELLS IN THE SEMEN

It is generally recognized that white blood cells in semen are detrime ntal to sperm function and fertility. Traditionally, pyospermia has be en suspected if greater than 10 round cells per high power field or mo re than 1 million round cells per ml. were identified in the semen. Si nce immature germ cells and white blood cells appear as round cells un der wet mount light microscopy, the relationship between increased num bers of round cells in semen and true pyospermia was examined. Semen a nalyses were performed on specimens from 627 infertility patients. The numbers of round cells per high power field and the number of round c ells per ml. of semen were recorded. Specimens from 57 patients (9%) p ersistently demonstrated greater than 10 round cells per high power fi eld or more than 1 million round cells per ml. and they were subjected to immunohistochemical staining against white blood cell surface anti gens. Greater than 1 million white blood cells per ml. were identified in only 20 patients (35%) and only 8 samples demonstrated more than 3 million white blood cells per ml. Of the patients with greater than 1 million white blood cells per ml. 65% had motilities of less than 60% compared to 49% of the patients with less than this amount of pyosper mia. This difference was not statistically significant. Round cells co unted on a per milliliter basis correlated better with results of immu nohistochemical staining than did round cells counted on a per high po wer field basis. These data demonstrate that the majority of patients with excess round cells in the semen do not have pyospermia and, there fore, empiric antibiotic therapy without further testing will likely b e unproductive.