Association between urogenital inflammation conditions and leukocytospermia: insights from a large-scale...

Leukocytospermia (LCS) is commonly identified during male infertility evaluation and is associated with impaired semen quality. However, the specific roles of various inflammatory conditions in LCS remain incompletely understood.

This cross-sectional study enrolled 9345 males who attended an andrology clinic during the period from April 2020 to March 2023. Demographic and lifestyle factors, medical history, and clinically defined urogenital inflammatory conditions (epididymitis, prostatitis, orchitis, and seminal vesiculitis) were obtained from questionnaires and clinical records. LCS was defined as >1 × 10⁶ peroxidase-positive leukocytes/mL of semen. Multivariable logistic regression models were used to assess associations with LCS and to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Of the 9345 men, 1068 (11.4%) had LCS. Men with LCS were slightly older and were more often smokers. Epididymitis (1.69% vs 0.85%, P = 0.007) and prostatitis (14.42% vs 10.61%, P < 0.001) were more common in men with LCS. Men with LCS also had lower semen volume, sperm concentration, progressive motility, total motility, total motile sperm count, and normal morphology, and higher sperm DNA fragmentation index and high DNA stainability. In the fully adjusted model, epididymitis (aOR = 1.88, 95% CI 1.10-3.21) and prostatitis (aOR = 1.37, 95% CI 1.14-1.66) were associated with higher odds of LCS. Estimates for orchitis and seminal vesiculitis were imprecise because these conditions were uncommon.

Epididymitis and prostatitis were associated with higher odds of LCS in men attending an andrology clinic. Our study findings support assessment of urogenital inflammatory conditions in men with LCS.