Antibiotic therapy and leukocytospermia: a prospective, randomized, controlled study.

OBJECTIVE

To determine the efficacy of common antibiotic therapies for treatment of leukocytospermia of unknown etiology.

DESIGN

Prospective, randomized, controlled clinical study.

SETTING

Fertility and Endocrinology Unit at Brigham and Women's Hospital, Boston, Massachusetts.

PATIENTS

One thousand seven hundred ten male partners in infertile couples attending the Fertility and Endocrinology Unit.

INTERVENTIONS

Concentrations of seminal peroxidase-positive granulocytes were determined during all routine semen analyses performed over a 30-month period. Of 119 men found to have leukocytospermia (> 10(6) granulocytes/mL semen) on first visit, 54 agreed to be randomized into one of three groups, and 41 patients completed the study. Group I (n = 13) and their wives received a 14-day course of oral doxycycline, 100 mg twice per day. Group II (n = 11) and their wives received a 14-day course of oral trimethoprim 160 mg-sulfamethoxazole 800 mg twice per day. Group III (n = 17) and their wives received no therapy. Four weeks after randomization, repeat semen analyses and granulocyte quantitations were done.

RESULTS

Neither of the antibiotic regimens resulted in a significantly higher rate of resolution of leukocytospermia over that seen in the control group.

CONCLUSIONS

There is a high rate of spontaneous resolution of leukocytospermia after one positive test. Antibiotics are no more beneficial than no therapy for treatment of this condition.