Department of Andrology, Guilin People's Hospital, Guilin, 541002, China.
Department of Medical Record Management, The First Affiliated Hospital of Hainan Medical University, Haikou, 571137, China.
BMC Urol. 2020 Oct 22;20(1):165. doi: 10.1186/s12894-020-00742-y.
Ureaplasma urealyticum (UU) infection, as well as asymptomatic leukocytospermia, whether it has effect on semen parameters and whether it needs screening and treatment is still a confusing and controversial topic for clinicians.
Among 1530 adult males who visited Guilin People's Hospital due to infertility, 295 were diagnosed with asymptomatic leukocytospermia, and 95 were further screened for UU-positive. 81 UU-positive asymptomatic leukocytospermia patients received 7-day or 14-day treatment plan with doxycycline, and 70 cases were cured. The semen parameters of non-leukocytospermia, leukocytospermia, UU-positive leukocytospermia and UU-negative leukocytospermia groups were compared, and the differences between the two treatment plans and the semen parameters before UU treatment and 1 month after UU-cured were compared.
Compared with non-leukocytospermia patients, the sperm concentration, progressive motility (PR), and normal morphology of patients with leukocytospermia decreased, while those with UU-positive leukocytospermia performed more significantly. The PR, total motility, and normal morphology of UU-positive leukocytospermia patients were significantly lower than those of UU-negative leukocytospermia patients (all p < 0.001). The UU cure rates of the 7-day and 14-day treatment plan with doxycycline was 84.62% and 89.66% (p = 0.738), respectively, and the sperm concentration, PR, total motility, and normal morphology of the cured UU-positive leukocytospermia patients were all increased after 1 month (p = 0.001, p = 0.022, p = 0.004 and p = 0.008, respectively).
It is significant to screen and treat UU infection in asymptomatic leukocytospermia for improving sperm quality. Where appropriate, the 7-day treatment plan with doxycycline may be a good choice.
解脲脲原体（UU）感染和无症状白细胞精子症是否会影响精液参数，是否需要筛查和治疗，这对临床医生来说仍然是一个令人困惑和有争议的话题。
在因不育而到桂林人民医院就诊的 1530 名成年男性中，295 名被诊断为无症状白细胞精子症，其中 95 名进一步筛查 UU 阳性。81 例 UU 阳性无症状白细胞精子症患者接受了为期 7 天或 14 天的多西环素治疗方案，其中 70 例治愈。比较非白细胞精子症、白细胞精子症、UU 阳性白细胞精子症和 UU 阴性白细胞精子症组的精液参数，并比较两种治疗方案与 UU 治疗前和 UU 治愈后 1 个月的精液参数的差异。
与非白细胞精子症患者相比，白细胞精子症患者的精子浓度、前向运动（PR）和正常形态下降，而 UU 阳性白细胞精子症患者下降更明显。UU 阳性白细胞精子症患者的 PR、总活力和正常形态明显低于 UU 阴性白细胞精子症患者（均 P<0.001）。多西环素 7 天和 14 天治疗方案的 UU 治愈率分别为 84.62%和 89.66%（P=0.738），UU 治愈后的 UU 阳性白细胞精子症患者的精子浓度、PR、总活力和正常形态均有增加（P=0.001、P=0.022、P=0.004 和 P=0.008）。
筛查和治疗无症状白细胞精子症中的 UU 感染对于改善精子质量具有重要意义。在适当的情况下，多西环素 7 天治疗方案可能是一个不错的选择。
