Too many white blood cells in semen may lead to impaired fertility

A white blood cell count is often one of the parameters measured during a semen analysis. While it is normal for semen to have some white blood cells, an elevated concentration may negatively affect fertility, and could indicate a potential health problem. This condition is called Leucocytospermia or Pyospermia.

According to the World Health Organization, pyospermia is defined as more than 1 million white blood cells per milliliter of semen.

The body’s immune system relies on white blood cells (leukocytes) to help fight infections caused by invading cells and bacteria.

Produced in the bone marrow, leukocytes move freely throughout the bloodstream, neutralising any foreign viruses, bacteria or fungi.

If an infection is present, the body responds by producing more white blood cells to stop the damaging cells.

Given that leukocytes can be found in any part of the body at any given time, it’s not usual for these cells to be in semen.

At low concentrations, white blood cells do not affect spermatozoa and therefore won’t negatively impact fertility.

However, high concentrations of leukocytes may decrease fertility in a condition is known as leukocytospermia. To be diagnosed with leukocytospermia, the white blood cell count within semen is over one million leukocytes per millilitre.

Is leukocytospermia common and what causes it?

A rare condition, leukocytospermia affects between 5% and 10% of men. Approximately 20% of males seeking fertility treatment are diagnosed with leukocytospermia.

There are a number of factors that can increase white blood cell count including genital tract infections, alcohol consumption, marijuana use, and tobacco smoking1. Prolonged abstinence and specific sexual practices, such as anal intercourse or the use of vaginal products (for hygiene and treatment), can also lead to leukocytospermia in men following sexual intercourse.

In some cases, men with abnormal sperm production will have high white blood cell counts as a defensive mechanism to remove defective sperm. Men who have undergone a vasovasostomy or varicocele can also have higher concentrations of leukocytes in their semen.

How does leukocytospermia affect fertility?

There is no clear understanding of the effects of an elevated white blood cell count on male fertility. Some studies report no adverse impacts of leukocytospermia2,3.

However, other studies have found a correlation between impaired semen parameters and leukocytospermia, especially in reference to sperm motility and morphology4,5,6.

One of the concerns of leukocytospermia is that it leads to cellular oxidation. This means that during the maturation process, sperm cells become damaged and this negatively affects mobility and morphology.

Once sperm cells are damaged, their capacity to fertilize the egg is significantly reduced. The higher the white blood cell count, the more likely sperm has been damaged by reactive oxygen species (ROS). However, the concentration of ROS can be altered by the presence of antioxidants.

This means that although semen may have a high level of white blood cells, it doesn’t necessarily lead to a reduction in fertility if they also have an elevated concentration of antioxidants to minimise ROS.

Treating leukocytospermia

If you have been diagnosed with leukocytospermia and you are having trouble with fertility there are several treatment approaches. Determining the underlying cause of an elevated white blood cell count in semen is the first course of action.

Patents may be tested for sexually transmitted diseases such as Gonorrhea and Chlamydia, and any other potential infections of the genital tract. If an infection is identified, antibiotics will be prescribed as treatment. This should restore the white blood cell count to within the normal range.

Diet also plays an important role in improving the fertility of men with leukocytospermia. A healthy diet enriched with key nutrients for supporting healthy sperm development can assist to improve fertility. Eating plenty of fresh fruits and vegetables will help to increase antioxidant concentrations within semen, effectively neutralizing ROS. There are also a range of fertility supplements that can be taken regularly to improve fertility.

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VIDEO: Learn How To Interpret A Semen Analysis (video 2 of our video series)

Bibliography

  1. “Close, C., Roberts, P. and Berger, E. (1990). Cigarettes, alcohol and marijuana are related to pyospermia in infertile men. Journal of Urology, 1990. Volume 144, Issue 4 (pp. 900-3.).”
  2. “Cottell, E., et al. (2000). Are seminal fluid microorganisms of significance or merely contaminants? Fertility and Sterility, Volume 74, Issue 3, (pp. 465-470).”
  3. “Rodin, D., Larone, D. and Goldstein, M. (2003) Relationship between semen cultures, leukospermia, and semen analysis in men undergoing fertility evaluation. Fertility and Sterility, Volume 79, Issue 3, (pp. 1555-8).”
  4. “Aziz, N., et al. (2004). Novel associations between specific sperm morphological defects and leukocytospermia. Fertility and Sterility. Volume 82, Issue 3, (pp.621-670.”
  5. “Esfandiari, N., et al. (2002). Positive bacterial culture of semen from infertile men with asymptomatic leukocytospermia. International Journal of Fertility and Women’s Medicine. Volume 47, Issue 6, (pp. 265-70).”
  6. “Thomas, J., et al. (1997). Increased polymorphonuclear granulocytes in seminal plasma in relation to sperm morphology. Human Reproduction. Volume 12, Issue 11, (pp. 2418-21).”