If a fertile couple consults a reproductologist, then a man must be prescribed seminal fluid analysis. This test shows the patient’s reproductive system. It often turns out that leukocytes are elevated in the spermogram. What pathologies do such test data testify to? And how dangerous is leukocytosis? We will consider these issues in the article.
What does leukocytosis indicate?
Normally, seminal fluid may contain a small amount of white blood cells. They are necessary to protect the reproductive organs from infections. However, their concentration in the analysis in healthy men is extremely small.
Often there are cases when the patient does not have any pronounced symptoms, but the leukocytes are increased in the spermogram. What does it mean? Such data indicate an inflammatory process. If an infection gets into the reproductive organs, then the immune system intensely produces white blood cells. Their greatest accumulation is noted around the lesion.
Why are white blood cells in the spermogram elevated if the man does not feel any signs of inflammation? Pathologies often proceed secretly. The inflammatory process is far from always accompanied by severe symptoms. Often, signs of the disease are detected by chance during the analysis of the ejaculate. Therefore, such a test must be passed necessarily. In approximately 20% of cases, male infertility is provoked by inflammation.
Analysis preparation
For the test to give reliable results, you need to properly prepare for the delivery of biomaterial. Sometimes there are cases when men have increased white blood cells in the spermogram due to non-compliance with hygiene before analysis. Therefore, on the eve of the study, you need to thoroughly wash the external genitalia.
Also, before the delivery of seminal fluid, you must strictly adhere to the following rules:
- Refrain from intimate life for 4-5 days before the breakdown.
- Do not take medicine or alcohol.
- Avoid overheating of the body before examination. Refuse to visit a bath or sauna.
- A day before sampling, do not engage in heavy physical work. Gym workouts should also be excluded.
- The biomaterial must be collected in a clean bowl. Any extraneous impurity can distort the analysis data.
This test is quite sensitive to the effects of random factors. Therefore, if the spermogram shows abnormalities, then doctors usually prescribe a re-examination. If violations are present in the data of several analyzes, then further diagnostics are carried out. According to its results, treatment is prescribed.
Normal performance
In the laboratory, biomaterial is examined under a microscope. If a man is healthy, then no more than 4 white blood cells can be in sight. Such data is the norm.
At the same time, other indicators of seminal fluid are necessarily evaluated:
- Number. Normally, the volume of biomaterial is 2-6 ml.
- Color. The liquid may have a white, yellowish or grayish tint. It should not contain turbid or purulent impurities.
- Acidity. The liquid has an alkaline reaction. Its pH should be between 7.2 and 7.8.
- The number of sperm in 1 ml of material. If the concentration of male germ cells is from 20 to 120 million, then this indicates a good state of reproductive function.
- Sperm viability. Sex cells can die under the influence of various factors. Even in healthy men, dead sperm can be detected in the analysis. But their concentration in the norm should not exceed 50% of the total number of cells.
- The structure of germ cells. Abnormally altered sperm can be detected in healthy patients. Such cells cannot participate in the process of fertilization. Normally, their indicator should be no more than 60%.
- The ability of sperm to move. If the content of motile cells is more than 25%, then this is a normal indicator.
- Viscosity. This is an important indicator of analysis. To evaluate the viscosity, a glass rod is placed in the biomaterial and they try to form a thread. If the size of the obtained drop does not exceed 5 mm, then this is considered the norm.
- Liquefaction period. Sperm loses viscosity and becomes liquid some time after ejaculation. In a healthy patient, the liquefaction period should not exceed 1 hour.
- Spermatogenesis. In the process of sperm formation, about 2% of epithelial cells can be desquamated. This is the norm.
- Mucus and red blood cells. These elements should be absent in the biomaterial. Only a very small number of mucous secretions are allowed.
Any deviation in the quality of the seminal fluid may make the conception process impossible. This analysis clearly shows the state of the reproductive system. However, to identify the causes of violations, the patient needs additional diagnostics.
Possible deviations
If the spermogram has elevated white blood cells, then this negatively affects other indicators of the test. Doctors suspect an inflammatory process if more than 4 white cells are found in the field of view of the microscope.
Let us consider in more detail how a high concentration of white blood cells affects the analysis data:
- The volume of biomaterial. Leukocytosis slightly affects this indicator. In some cases, the amount of seminal fluid may increase slightly.
- Color. The liquid acquires a saturated gray tint, may contain a cloudy impurity. If the inflammation is caused by bacteria, the ejaculate has a greenish or brown color.
- Acidity. It can vary both up and down.
- The concentration of sperm. With leukocytosis, this indicator usually does not exceed 60 million cells per 1 ml. However, the number of sperm can fall significantly below normal, which leads to infertility.
- Cell viability and motility. The patient decreases the number of live and motile sperm, which often makes fertilization impossible.
- The number of abnormal sperm. Sharply increased sperm with a changed structure.
- Viscosity and liquefaction time. This data is above normal. The droplet size is more than 5 mm. The liquefaction period may last more than 2 hours. The viscosity of the seminal fluid creates serious problems with conception.
- Indicators of spermatogenesis. With inflammation, the number of desquamated epithelial cells significantly exceeds the norm.
- Red blood cells and mucus. With advanced inflammation, these elements are excreted along with seminal fluid.
It can be concluded that an increased number of white blood cells in the spermogram reduces the quality of the ejaculate. Male factor infertility is often the result of latent or overt inflammation. The doctor examines all test data in a complex. This helps to make an accurate diagnosis.
Etiology of leukocytosis
Why do men have elevated white blood cells in a spermogram? The reason for this is inflammatory processes in the following organs:
- prostate gland;
- urethra
- the bladder;
- seminal vesicles;
- testicular tissue;
- external genitalia.
White blood cells are concentrated around the lesion and secreted along with the ejaculate. Most often, inflammatory processes are caused by bacteria, fungi, or viruses. In more rare cases, the pathology is associated with impaired blood circulation and lymph stagnation. This can be triggered by a sedentary lifestyle, obesity, hormonal disruptions.
Genital infections
Diseases transmitted through sexual contact can occur in men only after some time. At an early stage, the patient does not feel signs of inflammation. Only during the analysis, it is accidentally discovered that the patient has increased white blood cells in the spermogram. The cause of this may be infection with chlamydia or Trichomonas.
The incubation period with such pathologies is quite long. For example, the first signs of trichomoniasis can appear only a few weeks after infection. Chlamydia can make itself felt a month after infection, in addition, the disease in men often proceeds with minor symptoms.
Chlamydia and Trichomonas cause inflammation of the urethra. A man feels pain and burning during urination. Purulent mucous discharge comes out of the urethra. However, in men, these diseases often occur with erased symptoms.
There are times when the patient categorically denies the likelihood of infection. He cannot understand why his leukocytes in the spermogram are elevated. The cause of inflammation can be not only pathogenic, but also conditionally pathogenic microorganisms. These include, for example, Candida fungus.
This microorganism is present in every healthy person and does not cause any disease. But with a weakened immune system, the fungus begins to multiply excessively. And then a disease occurs - candidiasis. Most often, the active growth of the fungus leads to inflammation in the head and foreskin - balanoposthitis. The affected skin turns red, becomes covered with a white coating. The patient feels severe itching and burning. In advanced cases, fungal inflammation can go to the urethra, kidneys or bladder.
With gonorrhea, the patient has sharply increased white blood cells in the spermogram. This is one of the most dangerous genital infections. The disease is caused by a bacterium - gonococcus. An inflammatory process occurs in the urethra, accompanied by fever, soreness and burning during urination, purulent discharge. If treatment is not started in time, the infection can spread to the prostate gland and testicles.
Prostatitis
With inflammation of the prostate gland, the patient has increased white blood cells in the spermogram. Prostatitis is most often caused by bacteria and viruses. But the non-infectious origin of the pathology is also possible, when the inflammation is provoked by a sedentary lifestyle, being overweight or endocrine disorders.
The first sign of inflammation is an excessively frequent urge to urinate. They are especially worse at night. In this case, the allocation of urine is difficult. There are pains in the perineum, the temperature rises. Without treatment, inflammation becomes chronic.
Cystitis and urethritis
Elevated white blood cells in a man’s spermogram can be a sign of inflammation of the bladder or urethra. Urethritis is often triggered by sexual infections. Urination is accompanied by unpleasant sensations: pain and burning. Purulent discharge appears.
With cystitis, the bladder mucosa becomes inflamed. This disease is accompanied by fever and soreness in the lower abdomen. The patient is disturbed by false urge to urinate.
Vesiculitis
With this disease, an inflammatory process occurs in the seminal vesicles. Causes of pathology: infection, trauma, lack of exercise.
There is severe cutting pain in the scrotum, which radiates to the pelvis. The body temperature rises, the patient feels severe weakness. Red blood cells are often found in the spermogram.
Orchitis and epididymitis
With orchitis, the inflammatory process occurs in the testes, and with epididymitis, in their appendages. Often these two diseases occur together in one patient. Pathologies result from infection or injury. Orchitis can also be a complication of common infectious diseases: mumps, flu, measles, herpes.
These diseases are characterized by severe pain in the scrotum, poor health, and fever. External signs of inflammation are also noticeable: sharp redness of the skin in the affected areas, tissue tightening, swelling. Pain sensations radiating to the lower back.
Complications
An elevated white blood cell count in the spermogram is an alarming sign. Inflammatory diseases make the conception process difficult and sometimes impossible. Indeed, with leukocytosis, other spermogram indicators also worsen.
Launched inflammatory diseases in men lead to the following complications:
- Adhesions form in the vas deferens. This makes it difficult for sperm to escape, leading to infertility.
- Mutations in sperm occur. This can cause chromosomal abnormalities in the unborn child.
- Inflamed inflammation becomes chronic. This extremely negatively affects the potency of a man.
- Over time, the inflammatory process can trigger the appearance of malignant neoplasms.
Inflammatory diseases should not be triggered. You need to contact a urologist or andrologist as soon as possible.
Additional diagnostics
The increased content of leukocytes in the spermogram indicates only the presence of inflammation. However, the doctor must determine the localization of the pathological process. To select the most effective drugs, it is also important to identify the type of pathogen. In order to clarify the diagnosis, a man is prescribed additional examinations:
- urine analysis (general and for bacterial inoculation);
- a smear from the urethra (for the presence of bacteria and their sensitivity to drugs);
- Ultrasound or MRI of the prostate, bladder and external reproductive organs ;;
- cystoscopy;
- urethrography.
Therapies
What to do with elevated white blood cells in the spermogram? Treatment will depend on the cause of the abnormality. In most cases, the following types of drugs are prescribed to the patient:
- Antibiotics. The most common cause of inflammation is bacteria. Therefore, taking antibiotics is indispensable. Before prescribing drugs, it is necessary to determine the type of microorganism and its sensitivity to antibacterial drugs. Before receiving the results of the analysis for bacterial seeding, broad-spectrum drugs are used: Doxycycline, Azithromycin, Ciprofloxacin, Gentamicin.
- Antiviral drugs. If inflammation is provoked by viruses, but medications of the interferon group are prescribed: Viferon, Genferon.
- Antifungal agents. Their administration is indicated for candidiasis. Prescribe oral antimycotics: "Fluconazole", "Nystatin", as well as local ointments: "Pimafucin", "Clotrimazole".
- Anti-inflammatory drugs. The administration of drugs of the non-steroid group is shown: Ibuprofen, Nise, Ketanova. They help relieve pain.
- Vitamins and Supplements. The patient is prescribed "Speman", "Sperm Plant", "Selenium", "Spermactin". These complexes help improve the quality of seminal fluid.
Patient should avoid heavy physical exertion. But a little gymnastics will only benefit. Light exercises will help improve circulation in the pelvis. This contributes to the relief of inflammation and stimulates spermatogenesis.
A special diet with a lot of protein foods and foods with vitamin E is also shown. Spicy foods and alcohol should be discarded.
If a couple plans to have a baby, then a man needs to completely recover from inflammatory diseases. Otherwise, the fertilization process may become impossible. Also, one cannot exclude the risk of a sick child due to mutations in sperm.