Introduction

What is pyospermia?

Pyospermia, also known as leukospermia, is a condition where there are too many white blood cells in your semen.¹

Importance of preventing pyospermia

Pyospermia can be a serious condition if you are wanting or planning to have a child of your own. In more severe cases of pyospermia you can experience infertility, which is affecting your ability to have children. But you can also have pyospermia without experiencing any symptoms, this would not affect your ability to have children. This is important because around 30% of infertility is caused by pyospermia and yet it is still very poorly understood.^1,2

Understanding pyospermia^1,2,3

Causes and risk factors 

There are a lot of causes that can affect pyospermia, including:

• Infections
• Urethritis - inflammation in the urethra
• Prostatitis - inflammation in the prostate
• Narrowing in the urethra
• Common STIs - herpes, chlamydia, gonorrhea
• Autoimmune diseases
• Systemic illness
• Infrequent ejaculation
• Swollen veins in scrotum - varicoceles
• Frequent use of tobacco, alcohol, marijuana 

Symptoms 

Most men with pyospermia may not experience any symptoms at all. However, an infection is a cause of pyospermia, and symptoms of an infection include:

• Swelling
• Pain and discomfort when peeing - dysuria
• Yellow semen
• Jelly-like semen
• Fever

Diagnostic procedures

For you to get a diagnosis, your local GP may refer you to an urologist, who specialises in conditions affecting the urinary tract and the reproductive system or an andrologist, who specialises in only the male reproductive system. During your appointment, they may review your medical history, ask about your sexual health and may also do a physical examination. 

Diagnostic tests

It is necessary to carry out a semen analysis, where a sample of your semen would be examined under the microscope. They will also ask you for the following tests to help diagnose:

• Imaging tests - X-ray, CT scans or MRI scans for a detailed view of your genitourinary tract 
• Urine tests (Urinalysis) - a sample of your pee would be examined for potential infections
• Urine flow test - Measures the speed of your pee when using the bathroom

Strategies for pyospermia prevention 

There are a few things you can do to help prevent pyospermia.^3,4,5 One way is avoiding injuries in the pelvic region and reducing the risk of sexually transmitted infections. Some of the steps you can take to practise safe sex are:

• Use condoms whenever having sexual intercourse
• Get yourself tested regularly for STIs!
• Avoid having sex if you suspect your partner to have an STI

For maintaining a healthy white blood cell count, you can change some of the things from your diet, including:

• Reduce alcohol intake and only drink and moderation
• Avoid using recreational drugs, such as cannabis and tobacco products
• Increase exercise and physical activity
• Having a healthy and balanced diet

Medical interventions 

The treatment you receive will differ depending on what is causing pyospermia.^5,6 Antibiotics may be prescribed to treat pyospermia, for removing white blood cells from the semen. This would improve the quality and function of the sperm and increase the chances of fertility. Over-the-counter medication and nonsteroidal anti-inflammatory drugs can help to increase the sperm count. Your doctor will know what treatment is best for you.

Importance of regular screening and monitoring

It is important to make sure you have regular screening and monitoring to ensure everything is well and improvement is seen throughout the treatment.⁶

Potential complications and consequences of pyospermia

Impact on fertility and reproductive health 

Having pyospermia can have an impact on fertility and your reproductive health because the white blood cells in your semen can damage the healthy sperm by impairing their movement and damaging their DNA.^5,6,7 

If you are trying to get pregnant it can be disheartening, as it can be challenging, but not impossible. There are steps you can take to help prevent it, but it is also important to seek help when you are in need!

Summary

Pyospermia is a condition that causes a high amount of white blood cells in your semen. This can have an effect on your fertility if you wish to have children. There are many causes and its treatment will depend on the underlying cause, but it is important to seek medical help. 

You may feel awkward and nervous discussing symptoms affecting the private area or when you are not able to get pregnant. But it is important to remember that you are not alone and medical help is always available for you to take.