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Updated: Sep 20, 2026
The Examination of Peroxidase-Positive Leukocytes in Semen
Published on: January 19, 2024
Treatment with levofloxacin does not resolve asymptomatic leucocytospermia--a randomized controlled study
A Krisp1, S Hörster, J Skrzypek
1Department of Andrology and Venerology, University Hospital, Philipp University, Marburg, Germany. krisp@mailer.uni-marburg.de
Abstract:
The manual of the World Health Organization defines leucocytospermia as the presence of >1 x 10(6) white blood cells per ml semen. Most authors consider leucocytospermia to be a consequence of inflammation due to bacterial infection. However, the efficacy of antibiotic therapy was not unequivocally demonstrated until now. We started a prospective, randomized, controlled study in 36 patients, who consulted our department for infertility with leucocytospermia. None of the patients reported any symptoms of genital infection. The patients were assigned randomly to two groups: group 1 received 250 mg levofloxacin once a day over 10 days, patients of group 2 received no therapy. Semen analysis was repeated 2 weeks later. After administration of levofloxacin, a mean decrease of leucocyte count of 45.8 +/- 72.2% compared with a decrease of only 3 +/- 109.2% in the untreated group was observed. However, this difference is not statistically significant. There were no significant differences between the two groups with respect to leucocyte count, sperm count and sperm cell after treatment. We conclude from our study that antibiotic therapy does not provide benefit for treatment of asymptomatic leucocytospermia.
Insights
Antibiotic therapy, such as levofloxacin, does not significantly improve sperm parameters in men with asymptomatic leucocytospermia (high white blood cells in semen). This study found no benefit from treating this condition with antibiotics.
Area of Science:
- Reproductive Medicine
- Urology
- Andrology
Background:
- Leucocytospermia, defined as >1 x 10^6 white blood cells/mL semen by WHO, is often linked to bacterial infections.
- The effectiveness of antibiotic treatment for leucocytospermia remains uncertain.
- Asymptomatic cases, without reported genital infection symptoms, present a specific challenge for treatment decisions.
Purpose of the Study:
- To evaluate the efficacy of antibiotic therapy in treating asymptomatic leucocytospermia.
- To determine if levofloxacin improves semen parameters in infertile men with elevated white blood cell counts in semen.
Main Methods:
- A prospective, randomized, controlled study was conducted with 36 infertile patients diagnosed with leucocytospermia.
- Patients were randomly assigned to receive either 10 days of levofloxacin (250 mg/day) or no treatment.
- Semen analysis was performed before and two weeks after the intervention period.
Main Results:
- The levofloxacin group showed a mean decrease in leucocyte count of 45.8%, while the untreated group had a 3% decrease.
- This difference in leucocyte count reduction between the groups was not statistically significant.
- No significant differences were observed in leucocyte count, sperm count, or sperm cell parameters between the treated and untreated groups post-treatment.
Conclusions:
- Antibiotic therapy with levofloxacin does not offer a significant benefit for the treatment of asymptomatic leucocytospermia.
- Current evidence does not support the routine use of antibiotics for infertile men with elevated seminal white blood cells and no symptoms of infection.
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