White Blood Cells in Semen: Can They Affect Male Fertility?

A semen report can reveal findings you may not have expected, including an increased number of white blood cells. Pyospermia is one such finding that may be linked to inflammation in the male reproductive tract. Understanding its causes, diagnosis, and possible effect on sperm health can help you know what to discuss with your doctor.

Pregatips
Sperm health depends on more than count and movement. The environment in which sperm develop and travel also plays an important role. Inflammation within the male reproductive system can sometimes change this environment and may show up as an unexpected finding during a fertility evaluation.
Pyospermia is one condition associated with this type of inflammation. Although a routine semen examination may detect it, its significance can vary from person to person. Looking at the underlying cause and other sperm parameters helps doctors understand whether it needs treatment.

To understand pyospermia, its causes, and how semen inflammation may affect fertility, we spoke with Dr Geetha S, Senior Consultant - Obstetrics and Gynaecology, SPARSH Hospital, Sarjapur Road.

What Is Pyospermia?

Pyospermia, also called leukocytospermia, refers to an increased number of white blood cells, or leukocytes, in semen.

White blood cells are part of your immune system and normally help fight infections. However, a higher number in semen may indicate inflammation or infection in the male reproductive or genitourinary tract.

Pyospermia is generally identified when semen contains more than 1 million white blood cells per millilitre, although the clinical significance of this threshold has been debated.

What Causes Pyospermia?

Pyospermia can have several possible causes.

These may include:

  • Genital or urinary tract infections
  • Inflammation of the prostate or other reproductive organs
  • Sexually transmitted infections
  • Inflammation of the epididymis or testicles
  • Chronic inflammation of the genitourinary tract
  • Other conditions affecting the male reproductive system

What Are the Symptoms of Pyospermia?

Pyospermia itself may not cause noticeable symptoms. It may first be identified during a semen analysis performed as part of a fertility evaluation.

You may experience symptoms such as:

  • Burning or discomfort while urinating
  • Pelvic or testicular discomfort
  • Pain during ejaculation
  • Frequent urination
  • Unusual discharge
  • Fever or other signs of infection

How Is Pyospermia Diagnosed?

A semen analysis is usually the starting point. The laboratory examines the semen sample for sperm count, movement, shape and other characteristics. It can also identify an increased number of round cells.

If white blood cells are suspected, additional testing may confirm whether these cells are actually leukocytes.

Depending on your symptoms and medical history, your doctor may also recommend:

  • Urine or semen culture
  • Testing for sexually transmitted infections
  • Physical examination
  • Evaluation of the prostate and reproductive organs
  • Additional male fertility tests when required

Can Pyospermia Affect Fertility?

Pyospermia may affect fertility in some men, but it does not automatically cause infertility.

Inflammation and oxidative stress may interfere with sperm movement, sperm structure or DNA integrity, potentially making fertilisation more difficult.

Male fertility depends on healthy sperm production and function. Pyospermia in the male reproductive system can sometimes influence sperm quality.Dr Geetha S, Senior Consultant - obstetrics and gynaecology, SPARSH Hospital, Sarjapur Road

How Is Pyospermia Treated?

Treatment depends on why the white blood cells are present.

If your doctor identifies a bacterial infection, they may prescribe appropriate treatment. Other cases may require management of an underlying inflammatory or reproductive condition.

Your doctor may also discuss lifestyle measures that support overall sperm health, such as:

  • Avoiding smoking and tobacco
  • Limiting excessive alcohol intake
  • Maintaining a healthy weight
  • Exercising regularly
  • Avoiding unnecessary heat exposure to the testes
  • Following a balanced diet
  • Managing other conditions that may affect fertility

Does Pyospermia Go Away on Its Own?

It may resolve when the underlying inflammation or infection settles, but this cannot be assumed.

If pyospermia is found on a semen analysis, your doctor may decide whether further testing or treatment is needed based on your symptoms, medical history and other semen parameters.

A repeat semen analysis may also be recommended in some situations to see whether the finding persists.

When Should You See a Fertility Specialist?

Consider speaking with a fertility specialist if:

  • You have been trying to conceive without success
  • Your semen analysis repeatedly shows increased white blood cells
  • You have abnormal sperm count, movement or morphology
  • You have pelvic, testicular or urinary symptoms
  • You have a history of reproductive or urinary tract infections
  • Your doctor suspects an underlying male fertility problem
Pyospermia means a higher-than-usual number of white blood cells in semen. It may be linked to infection or inflammation and, in some cases, can affect sperm function through inflammation and oxidative stress. However, it does not automatically mean infertility. Finding and treating the underlying cause is the important step.

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FAQs on White Blood Cells in Semen: Can They Affect Male Fertility?

  1. Is pyospermia the same as a semen infection?
    No. Pyospermia indicates an increased number of white blood cells in semen, but this does not necessarily mean that a bacterial infection is present. Further evaluation may be needed to identify the cause.
  2. Can you get pregnant naturally with pyospermia?
    Yes, pregnancy can still occur. Pyospermia does not automatically mean that natural conception is impossible. Your overall sperm quality and both partners' fertility factors are important.
  3. Does pyospermia mean I have an STI?
    Not necessarily. Sexually transmitted infections can cause inflammation, but there are several other possible causes of white blood cells in semen.
Medically Reviewed By:
Dr Geetha S, Senior Consultant - Obstetrics and Gynaecology, SPARSH Hospital, Sarjapur Road