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Dr. Starks' research recently accepted and presented at the American Society of Reproductive Medicine

Title: THE EFFECTS OF PYOSPERMIA AND UREAPLASMA UREALYTICUM CULTURE POSITIVITY ON SEMEN QUALITY IN SUBFERTILE MEN.

John J McGill, MD2, Karen Baker, MD1, Christopher Starks, MD1, Yagil Barazani, MD1 and Edmund Sabanegh, MD11Department of Urology, Cleveland Clinic Foundation, 9500 Euclid Ave Cleveland, Ohio, United States, 44195 and 2Urology Institute, University Hospitals - Case Medical Center, 11100 Euclid Avenue Cleveland, Ohio, United States, 44106. 

Objective: To analyze the relationship between pyospermia, semen quality and the results of
Ureaplasma urealyticum testing in subfertile men.

Design: Retrospective Cohort Study

Materials and Methods: This is a retrospective cohort study of subfertile men (n=122) visiting a single institution
over a 5 year period with pyospermia and reflexive urine culture for Ureaplasma
urealyticum. Study subjects had follow up semen analyses (SAs) no less than 28 days
after Ureaplasma testing. The Wilcoxon rank-sum test was used to compare mean SAs
before doxycycline treatment and to compare the change in mean SAs in pyospermic
patients with positive (n=9) vs. negative (n=113) Ureaplasma cultures.

Results: Comparison of pyospermic men after antibiotic treatment with positive vs. negative
Ureaplasma cultures revealed no statistical difference in incident semen leukocyte
levels (3.73 vs. 2.59 x 106 WBC/mL, p = 0.92), volume (2.0 vs. 2.79 mL, p = 0.15),
concentration (39.43 vs. 49.27 M/mL, p = 0.95), motility (44.89% vs. 50.73, p = 0.31), or
strict morphology (5.0 vs. 4.97%, p = 0.40).

Comparison of the change between incident and follow up semen analyses after
antibiotic treatment in positive vs. negative Ureaplasma cultures did not reveal a
statistically significant difference in change in semen leukocyte levels (-0.2 vs. -1.66 x
106 WBC/mL, p = 0.50), volume (-0.17 vs. -0.05 mL, p = 0.55), concentration (6.88 vs. -
0.56 M/mL, p = 0.85), motility (8.56 vs. -0.11%, p = 0.16), or strict morphology (0.67 vs.
-1.12%, p = 0.18).

Conclusions: Ureaplasma culture positivity does not influence semen parameters and reflexive
Ureaplasma testing in the setting of pyospermia may be of limited utility.

Support: None