Spontaneous variation of leukocytospermia in asymptomatic infertile males

Objective: To investigate the spontaneous variation of leukocytospermia (> 1 million/mL) in semen samples from infertile men. Design: Prospective cohort study. Setting: Andrologic clinic at university hospital. Patient(s): Ninety-nine men evaluating for infertility causes. Intervention(S): Two semen analyses according the World Health Organization criteria combined with urologic investigation without any treatment. Main Outcome measure(s): Spontaneous (downward/upward) variation in leukocyte count, sperm concentration, total motility, and morphology between the two semen samples. Result(s): In the first semen analysis, 21% of men had leukocytospermia. By the second analysis, leukocyte concentrations were within the normal range in 9 of these 21 men, corresponding to a downward variation of 43%. In contrast, 7 of 78 patients with normal leukocyte levels at the first analysis had leukocytospermia at the second analysis, corresponding to an upward variation of 9%. The upward variation rates for sperm concentration, total motility, and morphology were 4%, 17%, and 4%, respectively. Downward variation rates were considerably higher for total motility and morphology (30% and 28%, respectively). Conclusion(s): The rate for spontaneous downward variation of leukocytospermia in the absence of treatment was 43% in this study. This rate should be taken into consideration when treating infertile men with leukocytospermia, because effective medical therapy is still lacking. (Fertil Steril((R)) 2008;90:1757-60. (c) 2008 by American Society for Reproductive Medicine.)