Abayomi B. Ajayi1, Bamgboye M. Afolabi2*, Victor D. Ajayi1, Ifeoluwa O. Oyetunji1, Oluwafunmilola R. Biobaku1, Adedamilola Atiba1, Joy Ehichioya1, Ibukun Ayelehin1, Ayodeji Adeoye1, Temilade Adesida1
Introduction: Pyospermia is often detected in semen, especially when investigating for male infertility. Pyospermia, in a significantly large number is often correlated with inferior sperm parameters and reduced fertility. Pyospermia may be a factor of a fundamental genitourinary infection. This study assessed the relationship between pus cells and semen parameters in infertile Nigerian males. Subjects and Methods: A cross-sectional descriptive study was carried out at Nordica Fertility Center, Lagos, Nigeria, from 2004 to 2009. A total of 907 subjects were analyzed. Subjects ages (years) were categorized into ≤30, 30.1 – 35, 35.1 – 40, 40.1 – 45, 45.1 – 50 and >50, BMI into <18.5 (underweight), 18.5-24.5 (normal), 25.0 – 29.9 (overweight) and ≥30 (obese) and pus cells into none, 1 – 2 and ≥3.
Results: Leucocytopenia of ≥3 per high power field (/hpf) occurred in 67 (7.4%) men. The overall means (±sd) of pus cells was 1.4 (0.9), 1.4 (0.7), 1.4 (0.7) and 1.6 (1.6) per high power field in all, normospermia, oligoospermic and azoospermic clusters of patients respectively. Mean (±sd) pus cells in semen was 6.0 (4.0), the highest, among obese
(BMI ≥ 30) azoospermic patients. The proportion of subjects with pyospermia of 1 – 2 was highest (323/346, 93.3%) among oligoospermic patients while that with pyospermia of ≥3 was highest (10/109, 9.2%) among azoospermic patients. Obese azoospermic patients were 1.8 times as likely to have ≥3/hpf pyospermia compared to normal normospermic patients (x ² = 0.05, P-value = 0.51, OR = 1.82, 95% CI: 0.30, 11.02). Mean progressive motility (%) was significantly reduced (t = 1.95, P-value = 0.03) among patients with ≥3/hpf pyospermia (33.75 ± 19.23) compared to those with 1 – 2/hpf pyospermia (38.58 ± 21.63). Patients with sperm oval head ≤ 30% had significantly higher pyospermia (t = 2.22, P-value = 0.013) than those with sperm oval head of >30%. Conclusion: Elevated pus cell counts were observed among obese azoospermic men, those with reduced sperm progressive motility and those
with lower count of sperms with oval head morphology. Clinicians should consider pyospermia relative to body mass index and mean progressive motility in their management of male infertility.
Pyospermia, Male Infertility, Progressive Motility, Oval Head, Nigeria 1.