[Effect of pyospermia on fertility. Studies by selective leukocyte staining, elastase determination and routine sperm parameters].

The effect of cellular immune response on male fertility was investigated. 92 patients--attending the out patient practice of our Andrological department and 15 patients undergoing vasectomy for sterilisation purpose--were included in this study. For measuring the cellular immune response granulocyte concentration and PMN-elastase level were investigated in ejaculate, former according to WHO manual, and PMN-elastase concentration by ELISA technic. Elastase is a very sensitive non organ specific marker of inflammation. Pathological granulocyte concentration was present in 10.8%, slightly elevated level in 4.3% of cases, totally in 15.1%. Pathological elastase level was found in 17.4%, slightly elevated in 16.3%, totally in 33.7% of cases. High level of correlation was present between the two parameters of inflammation r = 0.695. The incidence of the two parameters in fertile and subfertile patients groups was not significant. Conventional spermaparameters (cell concentration/ml, motility %, intensive motility %, morphology %) were significantly different in the leucospermic and non leucospermic patient groups, except cell concentration. (P = 0.06, P = 0.04, P = 0.03, P = 0.001). The incidence of high elastase level was very similar P = 0.07, P = 0.005, P = 0.03, P = 0.005. As conclusion of our investigation we conclude that cellular response could have a negative influence on male fertility as "side-effect" of the cytotoxic influences of immune defense.