Pyospermia (also referred to as leukocytospermia) is a condition in which there is an unusually high number of white blood cells in the semen. According to the World Health Organization, pyospermia is defined as more than 1 million white blood cells per milliliter of semen.
Pyospermia is an important condition in male fertility because white blood cells weaken the sperm and can damage its genetic material. White blood cells release powerful substances called reactive oxygen species (ROS), which destroy organisms that cause infections. Unfortunately, ROS can also affect healthy tissues, which includes sperm. ROS destroy the sperm membrane, impair sperm movement, and damage sperm DNA.
How common is pyospermia?
Less than 5% of men with a fertility problem are diagnosed with pyospermia.
What causes pyospermia?
Pyospermia can be caused by many different things, including:
- Inflammation (swelling)
- Autoimmune conditions (the body attacks itself)
- Urethra stricture (narrowing of the tube through which urine passes)
- Genital infections, such as herpes, gonorrhea, or chlamydia
- Varicocele (the veins coming from the testicle are dilated, or widened)
- Systemic illness (across the whole body)
- Infrequent ejaculation
- Use of tobacco, marijuana, and alcohol
Infections in the genitourinary system are one potential cause for pyospermia. Common organisms include E. coli, Mycoplasma, Ureaplasma, and Chlamydia. While most people with genitourinary infection will have symptoms, up to 10% of young adults will have no symptoms or only mild symptoms.
Because some genital infections can be passed through sexual contact and can usually be treated successfully, all men who are diagnosed with pyospermia should have urine tests to look for organisms that cause infection within the genitourinary tract.
Infections in the female reproductive tract can cause serious and permanent fertility problems. Therefore, even though the risk of having an infection is very low, men should wear a condom during intercourse until the urine tests show that there is no infection. In cases where the tests reveal an infectious organism, the spouse or partner should also be tested and treated.