International Journal of Infertility & Fetal Medicine

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VOLUME 5 , ISSUE 3 ( September-December, 2014 ) > List of Articles


The Effect of Doxycycline on Pus Cells and Oxidative Stress in Male Patients with Leukocytospermia

Richa Aggarwal

Citation Information : Aggarwal R. The Effect of Doxycycline on Pus Cells and Oxidative Stress in Male Patients with Leukocytospermia. Int J Infertil Fetal Med 2014; 5 (3):95-99.

DOI: 10.5005/jp-journals-10016-1089

License: CC BY-NC 4.0

Published Online: 01-04-2017

Copyright Statement:  Copyright © 2014; The Author(s).



The World Health Organization (WHO) has defined leukocytospermia as > 106 WBC/ml of semen. However, the clinical significance of leukocytospermia is currently a subject of controversy. Evidence from several recent studies indicates that leukocytospermia could significantly contribute to oxidative stress and male infertility. Several clinical trials have investigated the efficacy of antibiotic therapy to treat patients with pyospermia in an attempt to improve fertility. Currently, doxycycline is the most common antibiotic used to treat pyospermia though larger trials are needed to demonstrate its efficacy in treating pyospermia.

Materials and methods

Hundred male partners with semen analysis showing the presence of significant leukocytospermia (WBC > 1 × 106/ml), sterile semen culture and satisfying the inclusion and exclusion criteria were enrolled in the study and given doxycycline 100 mg bd for 14 days. Semen analysis for pus cells and oxidative stress (ROS) measurement was done before and after the treatment.


Mean pus cell count before and after treatment with doxycycline was 2.28 ± 1.26 × 106/ml and 1.21 ± 0.58 ×106/mL respectively, the effect being statistically significant (p < 0.05). Resolution of leukocytospermia was seen in 61.4% (54/88) cases after doxycycline treatment. Mean oxidative stress (RLU/ sec/million sperms) before and after doxycycline therapy was 79.72 ± 133.9 and 25.44 ± 47.8, the difference being significant (p < 0.05).


Study results show that treatment with broad spectrum antibiotic like doxycycline leads to significant decrease in the number of pus cells present in semen thereby significantly decreasing the oxidative stress.

How to cite this article

Aggarwal R. the Effect of Doxycycline on Pus Cells and Oxidative Stress in Male Patients with Leukocytospermia. Int J Infertil Fetal Med 2014;5(3):95-99.

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  1. WHO manual for standard investigation and diagnosis of the infertile couple. Cambridge: Cambridge University Press; 1993. p. 1-92.
  2. Recent advances in medically assisted conception. Report of a WHO Scientific group. WHO Tech Rep Ser 1992;820:1-111.
  3. The world health report 1996 fighting disease, folstering development. WHO, Geneva; 1996.
  4. Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988-1989). Hum Reprod 1991;6(6):811-816.
  5. Immunocompetent cells in human testis in health and disease. Fertil Steril 1987;48(3):470-479.
  6. WHO laboratory manual for the examination of human sperm and semen—cervical mucus interaction. 4th ed. New York, NY: Cambridge University Press; 1999. p. 128.
  7. Increased polymorphonuclear granulocytes in seminal plasma in relation to sperm morphology. Hum Reprod 1997;12(11):2418-2421.
  8. Nonsperm cells in human semen and their relationship with semen parameters. Arch Androl 2000;45(3):131-136.
  9. Effects of white blood cells on the in vitro penetration of zona-free hamster eggs by human spermatozoa. J Androl 1985;6:127-135.
  10. Functional significance of white blood cells in the male and female reproductive tract. Hum Reprod 1990;5(6):639-648.
  11. Impact of reactive oxygen species on spermatozoa: a balancing act between beneficial and detrimental effect. Hum Reprod 1995;10 (supp 1):15-21.
  12. Strategies of antioxidant defense. Eur J Biochem 1993;215(2):213-219.
  13. Mechanism, measurement, and prevention of oxidative stress in male reproductive physiology. Indian J Exp Biol 2005;43(11):963-974.
  14. Molecular mechanisms regulating human sperm function. Mol Hum Reprod 1997;3(3):169-173.
  15. Reactive oxygen species and human spermatozoa: physiology and pathology. Int J Androl 1997; 20(2):61-69.
  16. Relative impact of oxidative stress on male reproductive function. Curr Med Chem 2001;8(7):851-862.
  17. Differential incorporation of fatty acids into and peroxidative loss of fatty acids from phospholipids of human spermatozoa. Mol Reprod Dev 1995;42(3):334-346.
  18. Human sperm glutathione reductase activity in situ reveals limitation in the glutathione antioxidant defense system due to supply of NADPH. Mol Reprod Dev 1998;49(4):400-407.
  19. Formation of reactive oxygen species in spermatozoa of infertile patients. Fertil Steril 1992;57: 409-416.
  20. Role of oxidative stress and antioxidants in male infertility. J Androl 1995;16(6): 464-468.
  21. Free radicals, lipid peroxidation and sperm function. Reprod Fertil Dev 1995;7(4):659-668.
  22. Effect of sperm lipid peroxidation on fertilization. J Androl 1996;17(2):151-157.
  23. Reactive oxygen species generation and human spermatozoa: the balance of benefit and risk. Bioessays 1994;16(4):259-267.
  24. Generation of reactive oxygen species, lipid peroxidation, and human sperm function. Biol Reprod 1989;41(1):183-197.
  25. Analysis of lipid peroxidation mechanisms in human spermatozoa. Mol Reprod Dev 1993;35(3):302-315.
  26. Oxidative stress and male infertility. Indian J Med Res 2009;129(4):357-367.
  27. Increased oxidative deoxyribonucleic acid damage in the spermatozoa of infertile male patients. Fertil Steril 1997;68:519-524.
  28. Sperm DNA damage and its clinical relevance in assessing reproductive outcome. Asian J Androl 2004;6(2):139-148.
  29. Can mitochondrial DNA mutations cause sperm dysfunction? Mol Hum Reprod 2002;8(8):719-721.
  30. Differentiation of round cells in semen by means of monoclonal antibodies and relationship with male infertility. Fertil Steril 1992;60:1069-1075.
  31. Prospective study of leukocytes and leukocyte sub-populations in semen suggests that they are not a cause of male infertility. Fertil Steril 1993; 60:1069-1075.
  32. Comparative analysis of the ability of precursor germ cells and epididymal spermatozoa to generate reactive oxygen metabolites. J Exp Zool 1997;277(5):390-400.
  33. Positive myeloperoxidase staining (Endtz test) as an indicator of excessive reactive oxygen species formation in the semen. J Assist Reprod Genet 1995;12:70-74.
  34. Macrophages in semen are indicative of chronic epididymal infection. Arch Androl 1990;25(1):5-11.
  35. Identification and treatment of leukocytospermia in couples with unexplained infertility. J Reproduc Med 1995;40(9):625-629.
  36. The effect of doxycycline in infertile couples with male accessory gland infection: a double blind prospective study. Int J Androl 1986;9(2):91-98.
  37. Antibiotic therapy and leukocytospermia: a prospective randomized controlled study. Fertil Steril 1995;63:142-147.
  38. Improvement of semen quality in infected asymptomatic infertile male after bacteriological cure. Medicina (B Aires) 1998;58(2):160-164.
  39. Do bacterial infections cause reduced ejaculate quality? A meta-analysis of antibiotic treatment of male infertility. Behav Ecol 2003;14(1):40-47.
  40. Effectiveness and limits of antimicrobial treatment on seminal leukocyte concentration and related reactive oxygen species production in patients with male accessory gland infection. Hum Reprod 2000;15(12):2536-2544.
  41. The relationship of pyospermia and seminal fluid bacteriology to sperm function as reflected in the sperm penetration assay. Fertil Steril 1982; 37:557-564.
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