VALUE OF DETECTING LEUKOCYTOSPERMIA IN THE DIAGNOSIS OF GENITAL-TRACTINFECTION IN SUBFERTILE MEN

Objectives: To evaluate whether detection of leukocytospermia in a rou tine semen analysis is of diagnostic value in selecting men with an '' actual'' microbial infection and to assess the association between leu kocytospermia and a history of bacterial and viral infections. Design: Prospective clinical study. Setting: Infertility clinic at the Center for Reproductive Medicine, Academic Medical Center, Amsterdam, the Ne therlands. Patient(s): One hundred eighty-four men among subfertile co uples attending our infertility clinic. Intervention(s): The number of leukocytes was assessed in three semen samples. Serologic tests were performed, as was transurethral culture after digital prostatic massag e. Main Outcome Measure(s): Diagnosis of actual bacterial and viral in fections in relation to seminal leukocyte concentrations. The associat ion of a history of sexually transmitted diseases with seminal leukocy te concentration. Result(s): An actual bacterial infection was present in 39% of men, and 11% of men had an actual viral infection. The area under the receiver operating curve, which was used to determine wheth er detection of leukocytospermia was of diagnostic value in identifyin g men with actual bacterial or viral infections, was 0.55 and 0.56 for bacterial and viral infection, respectively. A past infection with N. gonorrhoeae was associated with the presence of leukocytospermia A pa st viral infection was not associated with leukocytospermia. Conclusio n(s): Detection of leukocytospermia appears to be of diagnostic value for selection of men with actual microbial infections, but leukocytosp ermia is associated with a history of gonorrhea. (Fertil Steril(R) 199 8;70:315-19. (C) 1998 by American Society for Reproductive Medicine.).