Branigan E F, Spadoni L R, Muller C H
Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle 98195, USA.
J Reprod Med. 1995 Sep;40(9):625-9.
To evaluate whether identifying men with leukocytospermia in couples with unexplained infertility and treating them with antibiotics improves pregnancy rates.
A prospective, cohort study of men with and without leukocytospermia was identified on a smear of semen using Bryan-Leishman stain. Cumulative six-month pregnancy rates were determined for members of the leukocytospermic group who responded to treatment with resolution of their leukocytospermia on a semen smear, those who failed to respond to treatment, those not treated and those without leukocytospermia.
Thirty-six of 53 men with leukocytospermia responded to antibiotic treatment, and 19 women in these 36 couples (53%) became pregnant within the six-month follow-up period. Only 7 of 17 (6%) of those who failed to respond to treatment had their partner become pregnant (P < .001). Partners of men with leukocytospermia and no treatment had a 6% pregnancy rate, and the women in 13% (5/42) of couples without leukocytospermia became pregnant (P < .001).
Leukocytospermia exists in a significant number of males with unexplained infertility and normal semen analyses. Identifying and successfully treating such men results in a significant improvement in pregnancy rates. These men may be a subgroup with male infertility that can be identified and treated.
评估在不明原因不孕的夫妇中识别出白细胞精子症男性并用抗生素治疗是否能提高妊娠率。
一项前瞻性队列研究，通过使用布莱恩-利什曼染色法对精液涂片进行检查，确定患有和未患有白细胞精子症的男性。对于精液涂片上白细胞精子症消失且对治疗有反应的白细胞精子症组成员、治疗无效的成员、未接受治疗的成员以及无白细胞精子症的成员，测定其累积六个月的妊娠率。
53名白细胞精子症男性中有36名对抗生素治疗有反应，这36对夫妇中的19名女性（53%）在六个月随访期内怀孕。治疗无效的17名男性中只有7名（6%）的伴侣怀孕（P < .001）。患有白细胞精子症但未接受治疗的男性伴侣的妊娠率为6%，无白细胞精子症的夫妇中13%（5/42）的女性怀孕（P < .001）。
大量不明原因不孕且精液分析正常的男性存在白细胞精子症。识别并成功治疗这些男性可显著提高妊娠率。这些男性可能是可识别和治疗的男性不育亚组。
