Seminal immune response in infertile men with leukocytospermia: effect on antioxidant activity

Objective: To investigate the incidence of leukocytospermia and relation to T helper cytokines, tumor necrosis factor alpha (TNFα) and interleukin-4 (IL-4), antisperm antibodies and antioxidant activity. Design: Semen samples from 176 infertile men and 24 fertile controls were investigated. Methodology: The protocol included tubal patency test, hysterosalpingography and laparoscopy and dye test and ovulation through mid-luteal phase progesterone for the wives. The husbands had semen analysis, cytomorphology evaluation and semen culture. Seminal TNFα and IL-4, antisperm antibodies, total antioxidant activity, superoxide dismutase and zinc were determined. Results: Leukocytospermia occurred in 44.3% of the infertile men compared to 12.5% of the fertile men (P<0.01). Thirty-six (20.5%) men had pathogenic bacterial organisms which constituted 46.2% of those with leukocytospermia. Sperm parameters were worse with leukocytospermia in terms of sperm count (P<0.01), total motility progressive motility (P<0.01), morphology, asthenozoospermia, sperm membrane integrity and antisperm antibodies. TNFα and IL-4 had an inverse relationship; the expression of TNFα was higher with leukocytospermia and bacteriospermia (P<0.001), while IL-4 was higher in fertile controls (P<0.005). Incidence of antisperm antibodies was higher with leukocytospermia. Total antioxidant activity, superoxide dismutase and zinc were lower with leukocytospermia. Conclusion: Leukocytospermia impairs sperm function through reduced antioxidant activity and enhanced T helper 1 modulation.