Seminal leukocytes and clinical outcomes with donor sperm insemination

Objective: To report the level of leukocytospermia in fertile donors' semen. Surprisingly, seminal leukocytes protect fertilization properties of sperm and are associated with normal or improved assisted reproductive technology outcomes in infertility patients. This raises the question of whether leukocytospermia exists in fertile men as well. We report a study of sperm donors who, by law in France, have to be of proven fertility. Design: Retrospective analysis. Setting: University laboratory. Patient(s): One hundred fifty-five donors were selected for cryobanking. Results of their sperm analyses were compared with those from 10,242 infertile men. Intervention(s): None. Main Outcome Measure(s): The men's first ejaculate was studied by cytologic analysis to determine the round cell and polymorphonuclear cell (PMN) contents. A total of 3,875 donor sperm inseminations (DSIs) were performed, and their outcomes were analyzed over an 8-year period. Result(s): PMN is more elevated in semen from infertility patients than in semen from fertile donors, but some donors (6.5%) had high leukocytospermia (>= 10(6)/mL). The post-DSI pregnancy rate was increased when round cells were present (P<.02) but not with higher PMN concentrations. Furthermore, high leukocytospermia was associated with an increased post-DSI miscarriage rate. Conclusion(s): In fertile donors, as in infertility patients, high leukocytospermia (>10(6)/mL) is associated with a normal pregnancy rate but an increased percentage of early pregnancy loss. (Fertil Steril (R) 2011; 96:1320-4. (c) 2011 by American Society for Reproductive Medicine.)