Pyospermia is a condition in which you have an unusually high number of white blood cells in your semen. It can weaken sperm cells and damage genetic material. Symptoms depend on the cause. Doctors who specialize in the urinary tract or male reproductive tract can diagnose and treat pyospermia.
Pyospermia is a condition in which you have an unusually high number of white blood cells in your semen.
Semen is the substance that your penis discharges when you have an orgasm. It contains male reproductive cells (sperm) and fluids made of proteins, vitamins and minerals that provide sperm with energy.
White blood cells (leukocytes) are part of your immune system. They help fight off infections. White blood cells release reactive oxygen species (ROS), which is a powerful substance that destroys organisms that cause infections. However, ROS can also affect healthy tissues, including sperm. ROS:
Another name for pyospermia is leukocytospermia (loo-koh-cy-toh-spur-mia).
Pyospermia can be serious if you wish to have a biological child. But it depends on its severity. A serious level of pyospermia can affect your ability to have a biological child (fertility). But asymptomatic pyospermia won’t affect your fertility. Asymptomatic pyospermia means you have high levels of white blood cells, but they don’t cause any symptoms.
It’s normal to have small amounts of white blood cells in your semen. If you have pyospermia, it means you have high amounts of white blood cells in your semen — more than 1 million white blood cells per 1 milliliter (mL) of semen.
Less than 5% of men or people assigned male at birth (AMAB) who have a fertility problem have pyospermia.
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Many people with pyospermia have no symptoms at all. But an infection is one possible cause of pyospermia. Symptoms of an infection that may cause pyospermia may include:
Semen is usually a white or light gray color. If white blood cells attack your cells, it may turn your semen yellow. Other causes of yellow semen may include:
Talk to a healthcare provider if you notice any changes to your semen. They can diagnose the cause and recommend the appropriate treatment.
Pyospermia causes may include:
Infections in the genitourinary system are one potential cause of pyospermia. The genitourinary system includes the organs that make up your reproductive system and urinary system. Common infections include:
Pyospermia isn’t contagious. But some of the infections that cause it can be contagious. Get treatment for any infections that cause pyospermia. If an STI causes pyospermia, you and your sexual partners must get treatment. If only one of you gets treatment, you can continue to pass the infection between you.
Pyospermia may affect your ability to have biological children. The high number of white blood cells in your semen may attack and damage your sperm, which can reduce your sperm’s ability to fertilize an egg (conception).
You may get a diagnosis from a healthcare provider who specializes in conditions that affect your urinary tract and reproductive system (urologist) or a provider who specializes in the male reproductive system (andrologist). They may:
They’ll also order tests to help confirm a pyospermia diagnosis.
A healthcare provider will order a semen analysis. During a semen analysis, a provider will examine a sample of your semen under a microscope. They’ll count the number of white blood cells in your sample and use that number to estimate how many white blood cells would exist in a milliliter of semen. They’ll then order a myeloperoxidase (MPO) stain to diagnose pyospermia. MPO is an enzyme, and its presence indicates pyospermia.
A healthcare provider may also order the following tests to help diagnose the cause of pyospermia:
Your treatment depends on what’s causing pyospermia. In some cases, pyospermia may get better on its own.
Eliminating white blood cells from semen can improve sperm function and increase pregnancy rates. A healthcare provider may prescribe antibiotics to treat pyospermia, even if your urine and sperm cultures don’t show any bacteria. Be sure to take the full course of antibiotics. If you don’t finish the entire course, an infection can return and be more challenging to treat.
A provider may also recommend over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may help improve your sperm count.
You can help prevent pyospermia by avoiding injuries to your pelvic region and reducing your risk of STIs. If you’re sexually active, it’s a good idea to:
You can also try to remove excess white blood cells from your semen by:
With proper treatment, the outlook for many people who have pyospermia is good. After treatment, sperm quality often gets better. Talk to a healthcare provider. They can give you a better idea of what to expect.
It depends. Many people recover from pyospermia with treatment. But sometimes it persists, and healthcare providers can’t determine a cause even with treatment.
See a healthcare provider if you and your partner aren’t able to get pregnant after at least a year of trying or if you have any symptoms of pyospermia.
Schedule and keep follow-up appointments with your provider. If the provider prescribes antibiotics, you may need a semen analysis several months after you complete the full course.
Pyospermia can make it more challenging to get pregnant, but it’s still possible. If you can’t get pregnant for over a year, you may have one or more other conditions (comorbidities) that make pregnancy difficult. A healthcare provider may recommend fertility treatments to help you and your partner achieve pregnancy, including in vitro fertilization (IVF) or intrauterine insemination (IUI).
A note from Cleveland Clinic
Pyospermia is when you have an unusually high number of white blood cells in your semen. It has many different causes, some of which may have painful or uncomfortable symptoms. Antibiotics, over-the-counter medications and lifestyle changes may treat some causes. More serious causes may require surgery.
You may feel nervous or awkward talking to a provider if you have symptoms that affect your genitals or you can’t achieve pregnancy. But it’s important to remember you’re not alone, and healthcare providers are here to help.
Last reviewed by a Cleveland Clinic medical professional on 06/21/2023.
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