Microscopic view of sperm and white blood cells symbolizing male infertility.

Decoding Male Infertility: Understanding Leukocytospermia and Genital Tract Infections

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Mira Elwood in Health & Wellness November 2025 • 4 min read.

"What you need to know about the connection between male genital health, sperm quality, and fertility."


Are you and your partner facing challenges in conceiving? Male infertility is a significant factor in many couples' struggles to have children, and understanding the underlying causes is crucial. One area of increasing focus is the role of male genital tract infections (MGTI) and leukocytospermia – a condition characterized by an elevated number of white blood cells in semen – in affecting sperm quality and overall fertility.

Leukocytospermia is diagnosed when a semen sample contains a white blood cell count exceeding 1 × 10^6 per milliliter, according to the World Health Organization (WHO). While this threshold serves as a standard, some experts question its clinical relevance in predicting the impact on sperm function and male infertility. Regardless, leukocytospermia remains a key indicator of potential infection or inflammation within the male reproductive system.

This article will delve into the connection between MGTI, leukocytospermia, and male infertility. We'll explore the common causes, diagnostic approaches, and potential treatment options, offering guidance and reassurance for those navigating these complex issues. Whether you're a man seeking to optimize your fertility or a partner supporting your loved one, this information will help you understand the steps you can take to address these challenges.

What Causes Male Genital Tract Infections and Leukocytospermia?

Microscopic view of sperm and white blood cells symbolizing male infertility.

Infections and inflammation within the male genital tract are responsible for 13% to 15% of fertility issues in couples. While various pathogens can be involved, Chlamydia trachomatis is a common culprit. Other microorganisms frequently identified include gonococcus, Escherichia coli, Proteus mirabilis, Streptococcus faecalis, and Pseudomonas. It's worth noting that inflammation isn't always due to infection; lifestyle and environmental factors can also play a role. Factors such as smoking and exposure to environmental toxins can also affect sperm health.

It’s also worth keeping in mind that sometimes positive culture results of some microorganisms in ejaculates shows positive results indicating an infection. Therefore, proper practices of semen collection is vital. It’s ideal to properly prepare the ejaculate to avoid contaminations to give accurate readings.

  • Infections: Bacterial infections like Chlamydia and E. coli are common causes.
  • Inflammation: Environmental toxins and lifestyle choices (smoking) can trigger inflammation.
  • Oxidative Stress: Imbalances in ROS levels damage sperm membranes.
  • Cytokines: Inflammatory molecules attract more leukocytes, exacerbating the issue.
Leukocytes, even in healthy individuals, are present in the male genital tract, but their numbers increase significantly when infection and/or inflammation occur. Once activated, these leukocytes produce excessive amounts of reactive oxygen species (ROS). While low levels of ROS are necessary for normal sperm function, excessive ROS can damage sperm membranes through a process called lipid peroxidation. This damage compromises sperm motility, acrosome reaction, and the ability to fuse with an egg. In addition to ROS, inflammatory cytokines and chemokines (such as IL-6, IL-8, IL-1β, and TNF-α) attract even more leukocytes to the site of inflammation, creating a cycle of inflammation and damage.

Moving Forward: Treatment and Management of MGTI and Leukocytospermia

If you suspect you have MGTI or leukocytospermia, it's crucial to consult a healthcare professional specializing in male reproductive health. Diagnosis typically involves a semen analysis to assess white blood cell count, sperm parameters, and potentially microbial cultures to identify any infections. Treatment approaches vary depending on the underlying cause and may include antibiotics to combat bacterial infections and antioxidants to reduce oxidative stress and inflammation. Lifestyle modifications, such as quitting smoking and reducing alcohol consumption, can also play a significant role in improving sperm health. Though this isn't a guarantee to improve sperm or increase fertility, it can aid in achieving a more desired outcome.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/b978-0-12-812501-4.00011-0, Alternate LINK

Title: Male Genital Tract Infections And Leukocytospermia

Journal: Oxidants, Antioxidants and Impact of the Oxidative Status in Male Reproduction

Publisher: Elsevier

Authors: Shu-Jian Chen, Gerhard Haidl

Published: 2019-01-01

Everything You Need To Know

1

What is leukocytospermia, and how is it diagnosed?

Leukocytospermia is diagnosed when a semen sample shows a white blood cell count exceeding 1 × 10^6 per milliliter, according to the World Health Organization (WHO). It indicates potential infection or inflammation within the male reproductive system, but some experts question whether this threshold accurately predicts the impact on sperm function and male infertility. Further investigation is needed to determine the underlying cause and appropriate treatment.

2

What are the primary causes of male genital tract infections (MGTI) and leukocytospermia?

Male genital tract infections (MGTI) can be caused by various pathogens, with *Chlamydia trachomatis* being a common one. Other microorganisms frequently identified include gonococcus, *Escherichia coli*, *Proteus mirabilis*, *Streptococcus faecalis*, and *Pseudomonas*. Also, inflammation can stem from lifestyle and environmental factors like smoking and exposure to toxins.

3

How do leukocytes and reactive oxygen species (ROS) affect sperm quality in cases of infection or inflammation?

When leukocytes are activated due to infection or inflammation, they produce excessive amounts of reactive oxygen species (ROS). While low levels of ROS are necessary for normal sperm function, excessive ROS can damage sperm membranes through lipid peroxidation, compromising sperm motility, the acrosome reaction, and the ability to fuse with an egg. This is exacerbated by inflammatory cytokines and chemokines that attract even more leukocytes.

4

What are the typical diagnostic and treatment approaches for male genital tract infections (MGTI) and leukocytospermia?

Diagnosis involves a semen analysis to assess white blood cell count, sperm parameters, and microbial cultures to identify infections. Treatment may include antibiotics to combat bacterial infections and antioxidants to reduce oxidative stress and inflammation. Lifestyle modifications, such as quitting smoking and reducing alcohol consumption, can also improve sperm health.

5

What role do cytokines and chemokines play in the cycle of inflammation and sperm damage related to leukocytospermia?

Cytokines and chemokines, such as IL-6, IL-8, IL-1β, and TNF-α, play a significant role by attracting more leukocytes to the site of inflammation. This creates a cycle where increased leukocytes release more ROS, leading to further sperm damage and compromised fertility. Understanding this cycle is crucial for developing targeted treatments to break the inflammatory cascade.

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