Asymptomatic Leukocytospermia and Assisted Reproductive Technology Outcomes: Reason for concern?
ABSTRACT Leukocytospermia, defined as ≥1×106 white blood cells (WBC)/ml of semen, is a condition frequently observed in infertile men. While symptomatic leukocytospermia is often associated with genital tract infections and managed accordingly, the clinical significance of asymptomatic leukocytosper...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Urologia
2025-08-01
|
| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000500300&lng=en&tlng=en |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849329415980318720 |
|---|---|
| author | Marie-Christin Reich Natalie Heide Peter Humaidan Sandro C. Esteves |
| author_facet | Marie-Christin Reich Natalie Heide Peter Humaidan Sandro C. Esteves |
| author_sort | Marie-Christin Reich |
| collection | DOAJ |
| description | ABSTRACT Leukocytospermia, defined as ≥1×106 white blood cells (WBC)/ml of semen, is a condition frequently observed in infertile men. While symptomatic leukocytospermia is often associated with genital tract infections and managed accordingly, the clinical significance of asymptomatic leukocytospermia remains uncertain—particularly in the setting of Assisted Reproductive Technology (ART). Seminal leukocytes, primarily neutrophils, play a physiological role in immune surveillance and tissue homeostasis. However, when excessively activated, they may generate high levels of reactive oxygen species (ROS), contributing to oxidative stress, sperm dysfunction, and DNA damage. This narrative review critically examines whether asymptomatic leukocytospermia adversely affects ART outcomes, including fertilization, embryo development, clinical pregnancy, and live birth rates. A synthesis of current evidence—including meta-analyses and large retrospective studies—suggests that asymptomatic leukocytospermia does not negatively impact these outcomes. Moreover, standard sperm preparation techniques and the widespread use of ICSI appear to neutralize any potential deleterious effects from seminal leukocytes. Given the absence of compelling evidence supporting its harmful impact on ART success, routine treatment of asymptomatic leukocytospermia—particularly with empiric antibiotics—is not recommended. Such interventions may disturb the natural immune balance, promote antibiotic resistance, and increase healthcare burdens without demonstrable benefit. Nonetheless, selective treatment may be justified in specific scenarios, such as recurrent implantation failure or early pregnancy loss. Further research is warranted to standardize leukocyte detection methods and to clarify the role of adjunctive therapies. Until more definitive data emerge, an individualized, evidence-based approach remains the most appropriate strategy for managing asymptomatic leukocytospermia in infertile men pursuing ART. |
| format | Article |
| id | doaj-art-a1c690cb23ec4b4abfbd8be6b0d5e6aa |
| institution | Kabale University |
| issn | 1677-6119 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj-art-a1c690cb23ec4b4abfbd8be6b0d5e6aa2025-08-20T03:47:16ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192025-08-0151510.1590/s1677-5538.ibju.2025.0166Asymptomatic Leukocytospermia and Assisted Reproductive Technology Outcomes: Reason for concern?Marie-Christin ReichNatalie HeidePeter HumaidanSandro C. Esteveshttps://orcid.org/0000-0002-1313-9680ABSTRACT Leukocytospermia, defined as ≥1×106 white blood cells (WBC)/ml of semen, is a condition frequently observed in infertile men. While symptomatic leukocytospermia is often associated with genital tract infections and managed accordingly, the clinical significance of asymptomatic leukocytospermia remains uncertain—particularly in the setting of Assisted Reproductive Technology (ART). Seminal leukocytes, primarily neutrophils, play a physiological role in immune surveillance and tissue homeostasis. However, when excessively activated, they may generate high levels of reactive oxygen species (ROS), contributing to oxidative stress, sperm dysfunction, and DNA damage. This narrative review critically examines whether asymptomatic leukocytospermia adversely affects ART outcomes, including fertilization, embryo development, clinical pregnancy, and live birth rates. A synthesis of current evidence—including meta-analyses and large retrospective studies—suggests that asymptomatic leukocytospermia does not negatively impact these outcomes. Moreover, standard sperm preparation techniques and the widespread use of ICSI appear to neutralize any potential deleterious effects from seminal leukocytes. Given the absence of compelling evidence supporting its harmful impact on ART success, routine treatment of asymptomatic leukocytospermia—particularly with empiric antibiotics—is not recommended. Such interventions may disturb the natural immune balance, promote antibiotic resistance, and increase healthcare burdens without demonstrable benefit. Nonetheless, selective treatment may be justified in specific scenarios, such as recurrent implantation failure or early pregnancy loss. Further research is warranted to standardize leukocyte detection methods and to clarify the role of adjunctive therapies. Until more definitive data emerge, an individualized, evidence-based approach remains the most appropriate strategy for managing asymptomatic leukocytospermia in infertile men pursuing ART.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000500300&lng=en&tlng=enInfertilityReproductive Techniques, AssistedOxidative Stress |
| spellingShingle | Marie-Christin Reich Natalie Heide Peter Humaidan Sandro C. Esteves Asymptomatic Leukocytospermia and Assisted Reproductive Technology Outcomes: Reason for concern? International Brazilian Journal of Urology Infertility Reproductive Techniques, Assisted Oxidative Stress |
| title | Asymptomatic Leukocytospermia and Assisted Reproductive Technology Outcomes: Reason for concern? |
| title_full | Asymptomatic Leukocytospermia and Assisted Reproductive Technology Outcomes: Reason for concern? |
| title_fullStr | Asymptomatic Leukocytospermia and Assisted Reproductive Technology Outcomes: Reason for concern? |
| title_full_unstemmed | Asymptomatic Leukocytospermia and Assisted Reproductive Technology Outcomes: Reason for concern? |
| title_short | Asymptomatic Leukocytospermia and Assisted Reproductive Technology Outcomes: Reason for concern? |
| title_sort | asymptomatic leukocytospermia and assisted reproductive technology outcomes reason for concern |
| topic | Infertility Reproductive Techniques, Assisted Oxidative Stress |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000500300&lng=en&tlng=en |
| work_keys_str_mv | AT mariechristinreich asymptomaticleukocytospermiaandassistedreproductivetechnologyoutcomesreasonforconcern AT natalieheide asymptomaticleukocytospermiaandassistedreproductivetechnologyoutcomesreasonforconcern AT peterhumaidan asymptomaticleukocytospermiaandassistedreproductivetechnologyoutcomesreasonforconcern AT sandrocesteves asymptomaticleukocytospermiaandassistedreproductivetechnologyoutcomesreasonforconcern |