The Effect of Pyospermia on Male Infertility: A Cross-Sectional Study in Sri Lanka

Abstract

Background: Pyospermia, characterized by an elevated number of leukocytes in semen, is associated with oxidative stress and impaired sperm function. This study investigates the relationship between pyospermia and seminal parameters among infertile men in Sri Lanka. Methods: A cross-sectional study was conducted among 105 male partners of infertile couples attending a fertility clinic in Sri Lanka. Semen samples were analyzed for volume, sperm count, motility, morphology, and pus cell count. Subjects were categorized into two groups: Group 1 (5-10 pus cells/HPF) and Group 2 (>10 pus cells/HPF). An age-matched control group of non-pyospermic men was included. Data were analyzed using the Wilcoxon signed-rank test and linear regression. Results: No significant differences were found between the control and moderate pyospermia groups (P > 0.05). However, severe pyospermia (>10 pus cells/HPF) significantly reduced sperm motility (P = 0.004) and morphology (P = 0.001). Regression analysis revealed strong negative correlations between pus cell count and both motility (R = 0.845, P = 0.001) and morphology (R = 0.900, P = 0.001). Conclusion: Pyospermia exceeding 10 pus cells/HPF adversely affects sperm motility and morphology, likely due to oxidative damage caused by leukocyte-derived reactive oxygen species (ROS). Early identification and management may improve fertility outcomes.