C Castellini1, S D'Andrea1, A Martorella1, E Minaldi1, S Necozione2, F Francavilla1, S Francavilla1, A Barbonetti1. 1. Andrology Unit, Department of Clinical Medicine, Life, Health and Environment Sciences, University of L'Aquila, L'Aquila, Italy. 2. Epidemiology Division, Department of Clinical Medicine, Life, Health and Environment Sciences, University of L'Aquila, L'Aquila, Italy.
Abstract
BACKGROUND: The association of leukocytospermia with male fertility is still under debate. OBJECTIVE: To evaluate the impact of leukocytospermia (≥1 × 106 white blood cells/mL of semen, according to the World Health Organization) in men attending a fertility clinic for couple subfertility, on fertility outcomes after assisted reproductive technology (ART) and on semen quality. MATERIALS AND METHODS: A systematic review with meta-analysis of case-control studies reporting mean ± standard deviation for values of different seminal parameters (sperm concentration, progressive motility, sperm morphology, sperm DNA fragmentation, semen volume, and Ph) and fertilization rate (FR), or the odds ratio (OR) for clinical pregnancy rate (PR) per cycle after ART in leukocytospermic and non-leukocytospermic patients was performed. A literature search was carried out in MEDLINE and SCOPUS for English-language studies published till June 2018. RESULTS: Twenty-eight case-controlled retrospective studies met the inclusion criteria, comparing fertility outcomes after ART or semen parameters in men with or without leukocytospermia. FR and PR after ART were not significantly different in the two groups. Leukocytospermic samples showed a lower sperm concentration (pooled SMD = -0.14; 95% CI: -0.28, -0.01, I2 = 71%, pfor heterogeneity < 0.00001) and a lower progressive motility (pooled SMD = -0.18; 95% CI: -0.29, -0.06; I2 = 59%, pfor heterogeneity < 0.0001). However, the significant differences disappeared, along with the large inter-study heterogeneity, when analyses were restricted to studies clearly reporting the inclusion of men without clinical evidence of seminal tract infection. DISCUSSION AND CONCLUSION: Leukocytospermia in men seeking consultation for couple subfertility is not associated with a reduced fertility after ART and with altered semen quality in populations asymptomatic for genital tract infection. Therefore, the current clinical criteria for definition of leukocytospermia should be re-assessed in subfertile couples attending a fertility clinic.
BACKGROUND: The association of leukocytospermia with male fertility is still under debate. OBJECTIVE: To evaluate the impact of leukocytospermia (≥1 × 106 white blood cells/mL of semen, according to the World Health Organization) in men attending a fertility clinic for couple subfertility, on fertility outcomes after assisted reproductive technology (ART) and on semen quality. MATERIALS AND METHODS: A systematic review with meta-analysis of case-control studies reporting mean ± standard deviation for values of different seminal parameters (sperm concentration, progressive motility, sperm morphology, sperm DNA fragmentation, semen volume, and Ph) and fertilization rate (FR), or the odds ratio (OR) for clinical pregnancy rate (PR) per cycle after ART in leukocytospermic and non-leukocytospermic patients was performed. A literature search was carried out in MEDLINE and SCOPUS for English-language studies published till June 2018. RESULTS: Twenty-eight case-controlled retrospective studies met the inclusion criteria, comparing fertility outcomes after ART or semen parameters in men with or without leukocytospermia. FR and PR after ART were not significantly different in the two groups. Leukocytospermic samples showed a lower sperm concentration (pooled SMD = -0.14; 95% CI: -0.28, -0.01, I2 = 71%, pfor heterogeneity < 0.00001) and a lower progressive motility (pooled SMD = -0.18; 95% CI: -0.29, -0.06; I2 = 59%, pfor heterogeneity < 0.0001). However, the significant differences disappeared, along with the large inter-study heterogeneity, when analyses were restricted to studies clearly reporting the inclusion of men without clinical evidence of seminal tract infection. DISCUSSION AND CONCLUSION: Leukocytospermia in men seeking consultation for couple subfertility is not associated with a reduced fertility after ART and with altered semen quality in populations asymptomatic for genital tract infection. Therefore, the current clinical criteria for definition of leukocytospermia should be re-assessed in subfertile couples attending a fertility clinic.
Authors: Allyson J Rosati; Brian W Whitcomb; Nicole Brandon; Germaine M Buck Louis; Sunni L Mumford; Enrique F Schisterman; J Richard Pilsner Journal: Hum Reprod Date: 2020-11-01 Impact factor: 6.918
Authors: Rakesh Sharma; Sajal Gupta; Ashok Agarwal; Ralf Henkel; Renata Finelli; Neel Parekh; Ramadan Saleh; Mohamed Arafa; Edmund Ko; Armand Zini; Nicholas Tadros; Rupin Shah; Rafael F Ambar; Haitham Elbardisi; Pallav Sengupta; Marlon Martinez; Florence Boitrelle; Mara Simopoulou; Paraskevi Vogiatzi; Jaime Gosalvez; Parviz Kavoussi; Hussein Kandil; Ayad Palani; Marcelo Rodriguez Peña; Osvaldo Rajmil; Gian Maria Busetto; Christina Anagnostopoulou; Sava Micic; Marco G Alves; Lucia Rocco; Taymour Mostafa; Juan G Alvarez; Sunil Jindal; Hassan N Sallam; Israel Maldonado Rosas; Sheena E M Lewis; Sami AlSaid; Mesut Altan; Hyun Jun Park; Jonathan Ramsay; Sijo Parekattil; Marjan Sabbaghian; Kelton Tremellen; Kareim Khalafalla; Damayanthi Durairajanayagam; Giovanni M Colpi Journal: World J Mens Health Date: 2021-06-09 Impact factor: 5.400