Center for Reproductive Medicine and Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
Urology. 2011 Dec;78(6):1320-5. doi: 10.1016/j.urology.2011.08.062.
To design a retrospective study in which infertile men with a seminal leukocyte count of 0.2-1 × 10(6) white blood cells [WBC]/mL were given doxycycline to examine the potential benefits of the treatment on the improvement of semen parameters and natural pregnancy outcomes. It has been reported that even low-level leukocytospermia (0.2-1.0 × 10(6) WBC/mL) could be harmful to male reproductive function and achievement of pregnancy.
The records of 223 patients were reviewed and 61 patients were identified with a leukocyte count of 0.2-1.0 × 10(6) WBC/mL. Of the 61 patients, 27 presented before 2006 and were not routinely treated for this level of leukocytospermia. These patients were our historic control population. Since 2006, 34 patients met these criteria and received empirical antibiotic therapy (treatment group).
The treatment of low-level leukocytospermia with doxycycline did not show statistically significant differences in the semen parameters among the treated patients. Although the therapy did not alter the semen parameters, low-level leukocytospermia resolved in 56% of the treatment group, well above the spontaneous resolution rate of 25% observed in historic controls. The natural pregnancy rate among the treatment group (15 of 32 [47%]) was significantly greater than that among the controls (5 of 25 [20%]). The odds ratio for pregnancy outcome was 3.7 (95% confidence interval 1.1-11.7; P = .04).
Low-level leukocytospermia might have deleterious effects on male fertility, and antibiotic therapy for such a condition might improve the natural pregnancy rate among infertile couples.
设计一项回顾性研究，纳入精液白细胞计数为 0.2-1×10(6)个/毫升的不育男性，给予多西环素治疗，以检验治疗对改善精液参数和自然妊娠结局的潜在益处。有研究报道称，即使是低水平的白细胞精液症（0.2-1.0×10(6)个/毫升）也可能对男性生殖功能和妊娠结局产生危害。
对 223 例患者的记录进行了回顾性分析，其中 61 例患者的白细胞计数为 0.2-1.0×10(6)个/毫升。在这 61 例患者中，有 27 例患者就诊于 2006 年之前，当时并未针对这一水平的白细胞精液症进行常规治疗，这些患者是我们的历史对照组。自 2006 年以来，有 34 例符合这些标准的患者接受了经验性抗生素治疗（治疗组）。
多西环素治疗低水平白细胞精液症并未显著改善治疗患者的精液参数。虽然该治疗并未改变精液参数，但治疗组中有 56%的患者的低水平白细胞精液症得到了缓解，明显高于历史对照组中 25%的自发缓解率。治疗组（32 例中的 15 例，47%）的自然妊娠率明显高于对照组（25 例中的 5 例，20%）。妊娠结局的优势比为 3.7（95%置信区间为 1.1-11.7；P=0.04）。
低水平白细胞精液症可能对男性生育能力产生有害影响，针对这种情况进行抗生素治疗可能会提高不孕夫妇的自然妊娠率。
