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Are seminal fluid microorganisms of significance or merely contaminants?
E Cottell1, R F Harrison, M McCaffrey
1Royal College of Surgeons in Ireland, Academic Department of Obstetrics and Gynaecology, Rotunda Hospital, Dublin, Ireland. ecottell@rcsi.ie
Objective:
To determine the contribution of urethral and skin flora to seminal fluid cultures and the relation between bacteriospermia and seminal leukocytes.
Design:
Prospective study.
Setting:
IVF-ET unit at a university teaching hospital.
Patient(S):
Sixty men starting an IVF-ET program.
Intervention(S):
Culture of sequential first-catch urine, midstream urine, and semen samples with evaluation of seminal leukocytes.
Main Outcome Measure(S):
A comparison of microbes from first-catch urine, midstream urine, and semen samples and the correlations of seminal microbes, elevated leukocyte concentrations, and pregnancy.
Result(S):
Microorganisms were detected in 37% of first-catch urine samples, 27% of midstream urine samples, and 51% of semen samples. Most microorganisms were gram-positive microbes and were common to both urine and semen samples. Mean and median leukocyte concentrations were 0.98 x 10(6)/mL and 0.10 x 10(6)/mL, respectively. There was no correlation between seminal microbes and raised leukocytes or between leukocytospermia and/or bacteriospermia and pregnancy.
Conclusion(S):
Microorganisms are commonly found in insignificant quantities in the semen of asymptomatic men. The frequent isolation of gram-positive microbes common to both urine and semen and the absence of a correlation with raised leukocyte concentrations suggest that bacteriospermia most commonly represents contamination.