Jung Jae Hung, Kim Myung Ha, Kim Jiye, Baik Soon Koo, Koh Sang-Baek, Park Hyun Jun, Seo Ju Tae
Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.; Institute of Evidence Based Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Institute of Evidence Based Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.; Yonsei Wonju Medical Library, Yonsei University Wonju College of Medicine, Wonju, Korea.
World J Mens Health. 2016 Dec;34(3):165-172. doi: 10.5534/wjmh.2016.34.3.165. Epub 2016 Dec 22.
Male factors account for 20% to 50% of infertility cases, and infection in the genitourinary tract may play a contributing role in up to 15% of male infertility. Leukocytospermia is a well-known indicator of infection or inflammation in the male sex glands and the urogenital tract. Although great deal of effort has been expended to elucidate definite management strategies in infertile men with leukocytospermia, the gold standard of treatment remains unclear. Until recently, broad spectrum antibiotics and antioxidants have been used in the treatment of leukocytospermia for male infertility to eliminate infection and reduce reactive oxygen free radicals produced inside cellular mitochondria as a result of inflammation. The present review reveals that antibiotics might improve sperm parameters, the rate of resolution of leukocytospermia, the bacteriologic cure rate, and even the pregnancy rate, although some reports conflict. Antioxidants might also have clinical benefits for sperm function as shown by studies. However, the data are insufficient to conclude whether antibiotics and antioxidants for the treatment of infertile men with leukocytospermia are effective or not. Better designed investigations into leukocytospermia are needed.
男性因素导致的不孕病例占20%至50%，而泌尿生殖道感染在高达15%的男性不育中可能起促成作用。白细胞精子症是男性性腺和泌尿生殖道感染或炎症的一个众所周知的指标。尽管已经付出了巨大努力来阐明白细胞精子症男性不育的确切管理策略，但治疗的金标准仍不明确。直到最近，广谱抗生素和抗氧化剂一直用于治疗男性不育的白细胞精子症，以消除感染并减少炎症导致的细胞线粒体内产生的活性氧自由基。本综述表明，尽管一些报告存在冲突，但抗生素可能会改善精子参数、白细胞精子症的缓解率、细菌治愈率，甚至妊娠率。研究表明，抗氧化剂对精子功能也可能有临床益处。然而，数据不足以得出用于治疗白细胞精子症男性不育的抗生素和抗氧化剂是否有效的结论。需要对白细胞精子症进行设计更合理的研究。
