Are viral infections the cause of leukocytospermia?

Leukocytospermia is defined as a leukocyte count of more than 1 x 106 ml-1 ejaculate. It may be a symptom of male accessory gland infection, but is also observed in up to 10% of asymptomatic patients presenting for infertility work-up. Pathogenic bacteria are not present in all of these semen samples. We attempted to find evidence for infection with cytomegalovirus, Epstein-Barr virus and herpes simplex virus by determining antibodies in serum in 130 patients with, and 80 patients without, leukocytospermia and by polymerase chain reaction in 50 further patients and controls. All semen samples with or without leukocytospermia were free from clinically significant concentrations of pathogenic bacteria. Only IgM antibodies against HSV were found more frequently in patients with leukocytospermia than in the controls (10.8 and 1.25%, respectively). All other virus antibody findings showed an equal frequency in both groups. The determination of HSV DNA in 50 further semen samples with, and 50 samples without, leukocytospermia revealed no positive results. Although our study indicates an association of herpes virus infection and leukocytospermia in 10% of cases, the mechanism of association is to be clarified.