FERTILITY AND STERILITY Copyright c 1992 The American Fertility Society
Vol. 58, No.5, November 1992 Printed on Q£id-{ree paper in U.S.A.
Differentiation of round cells in semen by means of monoclonal antibodies and relationship with male fertility·
Waltraud Eggert-Kruse, M.D.t:\: Wolfgang Tilgen, M.D. II Annegret Bellmann, M.D.t Benno Runnebaum, M.D.t Gerhard Rohr, M.D., Ph.D.§ University of Heidelberg, Heidelberg, Germany
Objective: To differentiate round cells in semen samples of subfertile men and evaluate the clinical significance during infertility investigation. Patients: One hundred and eight randomly chosen couples with a median duration of infertility of 4 (range, 1 to 20) years presenting at the outpatient infertility clinic of the University of Heidelberg, Germany. Main Outcome Measures: Differentiation of round cells in semen by means of monoclonal antibodies (mABs) and a streptavidin-biotin system for staining. Correlation of results with medical history, outcome of clinical examination, sperm analysis, microbial screening of both partners, evaluation of sperm functional capacity in vivo by means of the postcoital test (PCT) and in vitro with the standardized crossed sperm-cervical mucus penetration test (SCMPT) and the subsequent fertility in a prospective study. Results: The method used for differentiation of round cells proved to be practical and suitable for routine use. The percentage of leukocytes ranged from 0% to 58% with a median of 3%. Number of round cells and percentage of leukocytes did not differ markedly with regard to andrologic history, clinical findings, for example, varicocele, results of standard sperm analysis, and microbial colonization of semen samples. However, high rates of leukocytes of the round cells correlated with reduced sperm count and morphology and results of PCT. Leukocyte-positive (> 15% leukocytes) specimens were also significantly more frequent in case of inadequate SCMPT and reduced sperm penetration ability in vitro. Conclusions: In asymptomatic patients (in terms of genital tract infection), the majority of round cells consist of immature germ cells and 15%) were compared with the other males, with the exception that they reported more frequently on occupational exposure to toxic chemicals (6/12, 50%
PATIENTS (%) 30
30'
~~ o
..... .
10
% of Leucocytes 40
30
50
00
Figure 1 (A), Distribution of round cells. (B), Distribution of leukocytes.
total number of leukocytes per ejaculate (r = 0.89) (P < 0.0001) (Spearman's rank correlation). Therefore this parameter was taken for further analysis. To evaluate the relationship of round cells and leukocytes in semen with other criteria of male fertility, two groups of patients were selected with the Table 1
Relationship of Number of Round Cells and Percentage of Leukocytes in Semen Samples and Andrological History Percentage of leukocytes *
No. of round cells * Parameter Previous genital infection Genital surgery Varicocelectomy Mumps Alcohol Nicotine General medication Exposure to toxic chemicals Exposure to heat Stress (because of working conditions) Stress (because of infertility) Total
Total
16 21 9 43 73 36 7
(15.4) (20.2) (8.7) (41.3) (70.2) (34.6) (6.7)
Vol. 58, No.5, November 1992 Printed on Q£id-{ree paper in U.S.A.
Differentiation of round cells in semen by means of monoclonal antibodies and relationship with male fertility·
Waltraud Eggert-Kruse, M.D.t:\: Wolfgang Tilgen, M.D. II Annegret Bellmann, M.D.t Benno Runnebaum, M.D.t Gerhard Rohr, M.D., Ph.D.§ University of Heidelberg, Heidelberg, Germany
Objective: To differentiate round cells in semen samples of subfertile men and evaluate the clinical significance during infertility investigation. Patients: One hundred and eight randomly chosen couples with a median duration of infertility of 4 (range, 1 to 20) years presenting at the outpatient infertility clinic of the University of Heidelberg, Germany. Main Outcome Measures: Differentiation of round cells in semen by means of monoclonal antibodies (mABs) and a streptavidin-biotin system for staining. Correlation of results with medical history, outcome of clinical examination, sperm analysis, microbial screening of both partners, evaluation of sperm functional capacity in vivo by means of the postcoital test (PCT) and in vitro with the standardized crossed sperm-cervical mucus penetration test (SCMPT) and the subsequent fertility in a prospective study. Results: The method used for differentiation of round cells proved to be practical and suitable for routine use. The percentage of leukocytes ranged from 0% to 58% with a median of 3%. Number of round cells and percentage of leukocytes did not differ markedly with regard to andrologic history, clinical findings, for example, varicocele, results of standard sperm analysis, and microbial colonization of semen samples. However, high rates of leukocytes of the round cells correlated with reduced sperm count and morphology and results of PCT. Leukocyte-positive (> 15% leukocytes) specimens were also significantly more frequent in case of inadequate SCMPT and reduced sperm penetration ability in vitro. Conclusions: In asymptomatic patients (in terms of genital tract infection), the majority of round cells consist of immature germ cells and 15%) were compared with the other males, with the exception that they reported more frequently on occupational exposure to toxic chemicals (6/12, 50%
PATIENTS (%) 30
30'
~~ o
..... .
10
% of Leucocytes 40
30
50
00
Figure 1 (A), Distribution of round cells. (B), Distribution of leukocytes.
total number of leukocytes per ejaculate (r = 0.89) (P < 0.0001) (Spearman's rank correlation). Therefore this parameter was taken for further analysis. To evaluate the relationship of round cells and leukocytes in semen with other criteria of male fertility, two groups of patients were selected with the Table 1
Relationship of Number of Round Cells and Percentage of Leukocytes in Semen Samples and Andrological History Percentage of leukocytes *
No. of round cells * Parameter Previous genital infection Genital surgery Varicocelectomy Mumps Alcohol Nicotine General medication Exposure to toxic chemicals Exposure to heat Stress (because of working conditions) Stress (because of infertility) Total
Total
16 21 9 43 73 36 7
(15.4) (20.2) (8.7) (41.3) (70.2) (34.6) (6.7)
