If an infertile couple turns to a reproductive specialist, then the man must be prescribed an analysis of seminal fluid. This test shows the condition of the patient's reproductive system. It often turns out that leukocytes are elevated in the spermogram. What pathologies do such test data indicate? And how dangerous is leukocytosis? We will consider these issues in the article.
What does leukocytosis indicate
Normal 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 of he althy men is extremely low.
Often there are cases when the patient does not have any pronounced symptoms, but leukocytes are elevated in the spermogram. What does it mean? Such data speaks of an inflammatory process. If an infection enters the reproductive organs, the immune system intensively produces white blood cells. Greatesttheir accumulation is noted around the lesion.
Why are leukocytes elevated in the spermogram if a man does not feel any signs of inflammation? Pathologies quite often proceed hidden. The inflammatory process is not always accompanied by severe symptoms. Often, signs of the disease are discovered by chance during the analysis of the ejaculate. Therefore, such a test must be passed. In about 20% of cases, male infertility is caused by inflammation.
Preparing for analysis
In order 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 leukocytes in the spermogram due to poor hygiene before analysis. Therefore, on the eve of the study, you need to thoroughly wash the external genitalia.
Also, before donating seminal fluid, you must strictly adhere to the following rules:
- Abstain from intimate life for 4-5 days before the test.
- Do not take drugs or alcohol.
- Avoid overheating of the body before the study. Refuse to visit the bath or sauna.
- Do not engage in hard physical work the day before sampling. You should also exclude training in the gym.
- Biomaterial should be collected in clean dishes. Any foreign matter can distort the analysis data.
This test is quite sensitive to random factors. Therefore, if the spermogram shows deviations from the norm, then doctors usually prescribe a second study. If violations are present in the data of severalanalyzes, then further diagnostics are carried out. According to its results, treatment is prescribed.
Normal performance
In the laboratory, the biomaterial is examined under a microscope. If a man is he althy, then no more than 4 white blood cells can be in the field of view. This data is normal.
At the same time, other indicators of seminal fluid must be evaluated:
- Quantity. Normally, the volume of biomaterial is 2-6 ml.
- Color. The liquid may have a white, yellowish or grayish tint. It should not contain cloudy or purulent impurities.
- Acidity. The liquid is alkaline. 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 a he althy man, dead spermatozoa can be found in the analysis. But their concentration normally should not exceed 50% of the total number of cells.
- Structure of sex cells. Abnormally altered spermatozoa can also be found in he althy patients. Such cells cannot participate in the process of fertilization. Normally, their rate should be no more than 60%.
- The ability of sperm to move. If the content of mobile cells is more than 25%, then this is a normal indicator.
- Viscosity. This is an important indicator of the analysis. To evaluate the viscosity, a glass rod is placed in the biomaterial.and try to form a thread. If the size of the resulting drop does not exceed 5 mm, then this is considered normal.
- The liquefaction period. Sperm loses its viscosity and becomes liquid some time after ejaculation. In a he althy patient, the liquefaction period should not exceed 1 hour.
- Spermatogenesis. During the formation of spermatozoa, about 2% of epithelial cells can be shed. This is normal.
- Mucus and red blood cells. These elements must be absent in the biomaterial. Only a very small amount of mucus is allowed.
Any deviation in the quality of seminal fluid can make it impossible to conceive. 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 leukocytes are elevated in the spermogram, then this negatively affects other test indicators. Doctors suspect an inflammatory process if more than 4 white cells are found in the field of view of the microscope.
Let's take a closer look at how a high concentration of white blood cells affects the analysis data:
- Volume of biomaterial. Leukocytosis has little effect on 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, then the ejaculate has a greenish orbrown.
- Acidity. It can change both up and down.
- Sperm concentration. With leukocytosis, this figure usually does not exceed 60 million cells per 1 ml. However, sperm counts can fall well below normal, resulting in infertility.
- Cell viability and motility. The number of live and mobile spermatozoa decreases in the patient, which often makes fertilization impossible.
- The number of abnormal sperm. The parameters of spermatozoa with a modified structure are increasing sharply.
- Viscosity and thinning time. This data is over the top. The droplet size is more than 5 mm. The liquefaction period can last more than 2 hours. The viscosity of seminal fluid creates serious problems with conception.
- Indicators of spermatogenesis. With inflammation, the number of desquamated epithelial cells significantly exceeds the norm.
- Erythrocytes and mucus. With advanced inflammation, these elements are released along with the seminal fluid.
It can be concluded that an increased number of leukocytes in the spermogram reduces the quality of the ejaculate. Male factor infertility is often the result of latent or overt inflammation. The doctor considers all test data in a complex. This helps to make an accurate diagnosis.
Etiology of leukocytosis
Why do men have increased leukocytes in the spermogram? The reason for this is inflammatory processes in the following organs:
- prostate;
- urethra;
- bladder;
- seminal vesicles;
- testicular tissues;
- external genitals.
Leukocytes are concentrated around the lesion and are excreted 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.
Sexual infections
Diseases transmitted through sexual contact can appear 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 leukocytes in the spermogram. The reason for this may be infection with chlamydia or Trichomonas.
The incubation period for such pathologies is quite long. For example, the first signs of trichomoniasis may appear only a few weeks after infection. Chlamydia can make itself felt a month after infection, in addition, the disease in men often occurs 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 blurred symptoms.
There are times when a patient categorically denies the possibility of infection. He cannot understand why his leukocytes are elevated inspermogram. The cause of inflammation can be not only pathogens, but also conditionally pathogenic microorganisms. These include, for example, the fungus Candida.
This microorganism is present in every he althy person and does not cause any disease. But when the immune system is weakened, the fungus begins to multiply excessively. And then there is a disease - candidiasis. Most often, the active growth of the fungus leads to inflammation in the area of \u200b\u200bthe head and foreskin - balanoposthitis. The affected skin turns red, covered with a white coating. The patient feels severe itching and burning. In advanced cases, fungal inflammation can spread to the urethra, kidneys or bladder.
With gonorrhea, the patient's leukocytes in the spermogram are sharply increased. This is one of the most dangerous sexual 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 and testicles.
Prostatitis
With inflammation of the prostate gland, the patient has increased leukocytes in the spermogram. Prostatitis is most often caused by bacteria and viruses. But a non-infectious origin of the pathology is also possible, when inflammation is provoked by a sedentary lifestyle, excess weight or endocrine disorders.
The first sign of inflammation is excessive urge to urinate. They are especially intensified at night. In this case, the excretion of urine is difficult. Pain appears inperineum, the temperature rises. Without treatment, inflammation becomes chronic.
Cystitis and urethritis
Increased leukocytes in the spermogram of a man can be a sign of inflammation of the bladder or urethra. Urethritis is often provoked by sexual infections. Urination is accompanied by unpleasant sensations: pain and burning. Purulent discharge appears.
When cystitis inflames the mucous membrane of the bladder. This disease is accompanied by fever and pain in the lower abdomen. The patient is disturbed by false urge to urinate.
Vesiculitis
In this disease, an inflammatory process occurs in the seminal vesicles. Causes of pathology: penetration of infection, trauma, physical inactivity.
There is a strong cutting pain in the scrotum, which radiates to the small pelvis. The body temperature rises, the patient feels severe weakness. Erythrocytes are often found in the spermogram.
Orchitis and epididymitis
With orchitis, the inflammatory process occurs in the testicles, and with epididymitis - in their appendages. Often these two diseases occur together in the same patient. Pathologies appear as a result of infection or injury. Orchitis can also be a complication of common infectious diseases: parotitis, influenza, measles, herpes.
These diseases are characterized by severe pain in the scrotum, feeling unwell, fever. External signs of inflammation are also noticeable: a sharp reddening of the skin in the affected areas, tissue thickening, swelling. Painradiate to the lower back.
Complications
An increased level of leukocytes in the spermogram is an alarming sign. Inflammatory diseases make the process of conception difficult and sometimes impossible. Indeed, with leukocytosis, other indicators of the spermogram also deteriorate.
Advanced inflammatory diseases lead to the following complications in men:
- Adhesions form in the vas deferens. This makes it difficult for sperm to escape, leading to infertility.
- Mutations occur in spermatozoa. This can cause chromosomal abnormalities in the unborn child.
- Started inflammation becomes chronic. This has an extremely negative effect on the potency of a man.
- Over time, the inflammatory process can trigger the appearance of malignant neoplasms.
Inflammatory diseases cannot be started. 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 needs to 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, the man is prescribed additional examinations:
- urinalysis (general and bacteriological);
- urethral swab (for bacteria and drug sensitivity);
- Ultrasound or MRI of the prostate, bladder and externalreproductive organs;;
- cystoscopy;
- urethrography.
Therapy Methods
What to do with elevated leukocytes in the spermogram? Treatment will depend on the cause of the abnormalities. In most cases, the following types of drugs are prescribed to the patient:
- Antibiotics. The most common cause of inflammation is bacteria. Therefore, antibiotics are indispensable. Before prescribing drugs, it is necessary to determine the type of microorganism and its sensitivity to antibacterial drugs. Until the results of the analysis for bacterial culture are obtained, broad-spectrum drugs are used: "Doxycycline", "Azithromycin", "Ciprofloxacin", "Gentamicin".
- Antiviral drugs. If the inflammation is provoked by viruses, but preparations of the interferon group are prescribed: "Viferon", "Genferon".
- Antifungal agents. Their reception is indicated for candidiasis. Oral antimycotics are prescribed: Fluconazole, Nystatin, as well as local ointments: Pimafucin, Clotrimazole.
- Anti-inflammatory drugs. The use of drugs of the non-steroidal group is shown: Ibuprofen, Nise, Ketanov. They help relieve pain.
- Vitamins and dietary supplements. The patient is prescribed Speman, Sperma Plant, Selenium, Spermaktin. These complexes help improve the quality of seminal fluid.
The patient should avoidheavy physical activity. But a little gymnastics will only benefit. Light exercise will help improve blood circulation in the pelvis. This contributes to the relief of inflammation and stimulates spermatogenesis.
A special diet with plenty of protein and vitamin E foods is also shown. Avoid spicy foods and alcohol.
If a couple plans to have a baby, then the man needs to be completely cured of inflammatory diseases. Otherwise, the fertilization process may become impossible. Also, the risk of a sick child due to mutations in spermatozoa cannot be ruled out.
