Sperm morphology and male urogenital infections
The aim of this study was to investigate the influence of urogenital infections as indicated by leukocytospermia on human sperm morphology, diagnosed cytologically and by means of a leukocyte peroxidase test. A basic semen analysis, including a leukocyte peroxidase test, was prospectively performed on 150 consecutive semen samples. Cytology smears were microscopically investigated for the presence of WBC and the results expressed on a 4 point scale as ± to + + + WBCs/high power field (HPF). ROC curve analysis indicated that for cases with more than ± WBC/HPF the peroxidase determined WBC count cut-off value was >0.25 x 106 WBC ml-1 with a sensitivity of 75% and specificity of 90%. The presence of more than ± WBC/HPF was negatively correlated with sperm morphology characteristics studied. The mean (± SD) percentage of morphological normal spermatozoa was 7.0% (SD 4.4) in the WBC negative group (n= 134) compared to 4.3% (SD 3.5) in the WBC positive (n = 16) group (P< 0.0001). There was also an associated increase, 15.3% (SD 13.3) to 23.6% (SD 13.8), in the percentage of spermatozoa with elongated head forms in the WBC positive group (P=0.0218). No other effect on sperm and acrosome morphology could be found. With the peroxidase determinations there was also a tendency in the WBC positive group (n = 10) towards poorer sperm morphology characteristics, but these changes were not statistically significant. The presence of urogenital infections as diagnosed cytologically was associated with statistically poorer sperm morphology characteristics. This statistical relationship was not found in the peroxidase diagnosed leukocytospermia positive groups.