Leukocytospermia
Human semen is a heterogeneous fluid which contains a variety of cellular elements beyond spermatozoa. Several immunologic factors are present in human semen, such as chemokines, immunoglobulins, and growth factors [16], as well as a subset of WBC's. The microscopic evaluation of almost all semen samples will display nonspermatozoal cells, in particular WBC's [17], which encompass various forms such as granulocytes, lymphocytes, and macrophages [ 13]. An abnormally high concentration of WBC's in the semen is a condition called leukocytospermia, also referred to as leukospermia, pyospermia, or pyosaemia [18]. An increased concentration of leukocytes is the basic molecular defense mechanism against the detection of foreign organisms. The World Health Organization (WHO) criteria defines leukocytospermia as the presence of >1 x 106 WBC's/mL of semen [18]. This threshold is regarded as a possible indicator of an ongoing male genital tract infection [18]. Specifically, the detection of pathological concentrations ofleukocytospermia with the exclusion of a bladder infection or urethritis has been suggested as a basic diagnostic tool in recognizing genital tract infection [19, 20].
The activation of PMNL, which constitute 50-80% of the total seminal WBC count [8, 21][ results in releasing a protease by degranulation known as elastase [22] [ The presence of this particular protease is considered a highly reliable and sensitive marker of an asymptomatic infection [23] and can be used in diagnosing a clinically silent illness [ 24 ] . At present, due to the fact that the condition is asymptomatic and various sites in the reproductive system can be affected, the exact location of the origin of excess leukocytes is unknown [25, 26]. Due to the lack of understanding as to where exactly leukocytes are produced from, their release may be initially prompted by an inflammatory response of the genital tract to a bacterial invasion and then continually produced in their absence by immunological activity [7].
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