ANTIBIOTIC-THERAPY AND LEUKOCYTOSPERMIA - A PROSPECTIVE, RANDOMIZED, CONTROLLED-STUDY

Objective: To determine the efficacy of common antibiotic therapies for treatment of leukocytospermia of unknown etiology. Design: Prospective, randomized, controlled clinical study. Setting: Fertility and Endocrinology Unit at Brigham and Women's Hospital, Boston, Massachusetts. Patients: One thousand seven hundred ten male partners in infertile couples attending the Fertility and Endocrinology Unit. Interventions: Concentrations of seminal peroxidase-positive granulocytes were determined during all routine semen analyses performed over a 30-month period. Of 119 men found to have leukocytospermia (>10(6) granulocytes/ml semen) on first visit, 54 agreed to be randomized into one of three groups, and 41 patients completed the study. Group I (n = 13) and their wives received a 14-day course of oral doxycycline, 100 mg twice per day. Group II (n = 11) and their wives received a 14-day course of oral trimethoprim 160 mg-sulfamethoxazole 800 mg twice per day. Group III (n = 17) and their wives received no therapy. Four weeks after randomization, repeat semen analyses and granulocyte quantitations were done. Results: Neither of the antibiotic regimens resulted in a significantly higher rate of resolution of leukocytospermia over that seen in the control group. Conclusions: There is a high rate of spontaneous resolution of leukocytospermia after one positive test. Antibiotics are no more beneficial than no therapy for treatment of this condition.