Pus cells in the semen - and how to make sense of the report

 One of the common findings in a semen analysis report is the presence of a few pus cells per high power field ( pus cells/ hpf). The technical word for this is called pyospermia or leucocytospermia.Pus cells are WBCs - white blood cells, and less than 5 pus cells / hpf is considered to be normal, but this finding is often highlighted in red as being abnormal, and this often causes both the doctor as well as the patient to worry.The WHO Manual states that less than 1 million WBC per ml is normal, but the majority of labs never bother to measure the actual concentration of the WBCs - the technician simply eyeballs the sample and estimate this in terms of rounds cells seen in each visual field when scanning the samples through the microscope.Patients are worried that these pus cells suggest they are suffering from an occult infection - perhaps a sexually transmitted disease ( STD) which they knew they had acquired in the past, and they are worried that they can transmit this to their wife.They are also worried that this hidden infection can kill their sperm, or reduce their ability to fertilise the eggs.Doctors are also happy to "treat" this abnormality by putting the man on antibiotics, because these are so easy to prescribe, and because this seems to be a logical thing to do. They hope these antibiotics will kill the bugs causing the infection, and this will boost the man's fertility.The reason this is flawed logic is because the "pus cells" seen on a semen analysis repo...
Source: Dr.Malpani's Blog - Category: Reproduction Medicine Source Type: blogs