Seminal immune response in infertile men with leukocytospermia: effect on antioxidant activity

Objective: To investigate the incidence of leukocytospermia and relation to T helper cytokines, tumor necrosis factor alpha (TNF alpha) and interleuki n-4 (IL-4), antisperm antibodies and antioxidant activity. Design: Semen sa mples from 176 infertile men and 24 fertile controls were investigated. Met hodology: The protocol included tubal patency test, hysterosalpingography a nd laparoscopy and dye test and ovulation through mid-luteal phase progeste rone for the wives. The husbands had semen analysis, cytomorphology evaluat ion and semen culture. Seminal TNF alpha and IL-4, antisperm antibodies, to tal antioxidant activity, superoxide dismutase and zinc were determined. Re sults: Leukocytospermia occurred in 44.3% of the infertile men compared to 12.5% of the fertile men (P<0.01). Thirty-six (20.5%) men had pathogenic ba cterial organisms which constituted 46.2% of those with leukocytospermia. S perm parameters were worse with leukocytospermia in terms of sperm count (P <0.01), total motility progressive motility (P<0.01), morphology, asthenozo ospermia, sperm membrane integrity and antisperm antibodies. TNF alpha and IL-4 had an inverse relationship; the expression of TNF alpha was higher wi th leukocytospermia and bacteriospermia (P<0.001), while IL-4 was higher in fertile controls (P<0.005). Incidence of antisperm antibodies was higher w ith leukocytospermia. Total antioxidant activity, superoxide dismutase and zinc were lower with leukocytospermia. Conclusion: Leukocytospermia impairs sperm function through reduced antioxidant activity and enhanced T helper 1 modulation. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.