Effect of seminal leukocytes on in vitro fertilization and intracytoplasmic sperm injection outcomes

Capsule:
Leukocytospermia (1  106 leukocytes/mL), assessed by flow cytometry, does not significantly influence IVF or ICSI outcomes. The same results were obtained by using lower or higher cut-off values for leukocytospermia (from 0.2 to 2  106/mL).

Authors:
Giuseppe Ricci, M.D., Marilena Granzotto, Ph.D., Stefania Luppi, Ph.D., Elena Giolo, Ph.D., Monica Martinelli, Ph.D., Gabriella Zito, M.D., Massimo Borelli, Ph.D.

Volume 104, Issue 1, Pages 87–93

Abstract:

Objective:
To investigate the influence of seminal leukocytes on conventional IVF and intracytoplasmic sperm injection (ICSI) outcomes, using a flow cytometry method.

Design:
Prospective study.

Setting:
Tertiary infertility center and research institute.

Patient(s):
One hundred sixty-four couples undergoing conventional IVF or ICSI.

Intervention(s):
Seminal leukocytes were counted by flow cytometry.

Main Outcome Measure(s):
Correlation between seminal leukocytes concentration and reproductive outcomes in IVF and ICSI cycles.

Result(s):
The median number of oocytes retrieved, the fertilization and cleavage rate, the median number and grade of embryos transferred, the median number of good-quality embryos transferred, and the median percentage of good-quality embryos from total embryos transferred, in leukocytospermic and non-leukocytospermic patients were not statistically different after either IVF or ICSI. Similarly, there were no significant differences between the two groups for implantation rate and clinical pregnancy rate. Multivariate logistic regression analysis showed that the reproductive outcomes were not influenced by adjustment for female age, infertility diagnosis, number of previous attempts, treatment protocol (GnRH agonist or antagonist), assisted reproduction procedure (IVF or ICSI), and leukocytospermia. By profiling the proper Poisson regression models, no leukocytospermia cut-off value was able to identify the subjects at risk for oocyte fertilization or embryo cleavage failure.

Conclusion(s):
Using a flow cytometry method, we demonstrated that leukocytospermia does not significantly influence IVF or ICSI outcomes. The same results were obtained by using lower or higher cut-off values for leukocytospermia (from 0.2 to 2 × 106/mL).

  • msamplaski

    This manuscript adds to
    the body of literature available for seminal leukocytes and ART outcomes.
    Several questions arise. What is the specificity of flow cytometry for
    leukocytes? Were these men treated with antibiotics prior to their IVF/ICSI
    cycle? What is the widespread applicability of using flow cytometery for
    IVF/ICSI semen sample selection?

  • Thank you for this publication. Leukocytospermia can be difficult to treat and sometimes can have quite an impact on SA quality. With ART, the processing of the sperm to prepare it for use decreased the # of WBC. Despite the lack of differences in ART outcome for + or – WBC, I am unsure as to how this can be since the likely impact of ROS has already been realized by the time sperm is ejaculated for processing. This may demonstrate the utility of flow cytometry in this situation or that WBC and ROS may not be as big of an issue as previously thought. However, this is only 1 paper that demonstrates this compared to the myriad of others that show a negative impact with increasing WBC in semen.

  • ranjithrama

    The authors should be congratulated for evaluating the role of leukocytospermia on ART. Several physicians spend quite a bit of effort evaluating and treating leukocytospermia. The role of WBC in semen is unclear both for natural conception and ART success

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