neutrophilic polymorphs

[jk5]

I am a male who is not looking to have a child for severel years, as I am only 25 and far from married, but after finding a variocele on my left testicle, I had a sperm count test to see if any treatment for the variocele was necessary. The count was ok at 105 million/ml but there was a 34 million/ml round cell count (test range less than 5 million/ml) which my urologist said could be a lab error or an infection or inflammatory reaction but nothing to really worry about. He never suggested that a retest or treatment was necessary either, and nothing else was mentioned on the subject. The test showed these round cells were approximately 65% neutrophilic polymorphs. Since seeing my urologist, I have suddenly worried that if there is an infection present in my sperm/testicle, that I should treat it now so as not to affect my fertility in the future. My urologist did not suggest doing anything at all about the round cells as the sperm count was ok but almost just mentioned the round cells in passing. Also is it ok to have unproteced sex with my girlfriend as I don't know whether this infection (indeed if there is one present) could infect her with anything harmfull!!? Indeed, could this infection be seriously harming me!? Am I just being stupid, as my urolgoist did not suggest I should be having any of these worries. Indeed, I have thought of these concerns myself after seeing him. If possible I would rather just forget about this issue and not have any treatments/antibiotics etc or retests until it possibly ever became a fertility issue when trying for a child, and just have unprotected sex with my girlfriend without worrying about infecting her with... well nothing I think! Please help to put my mind at rest by responding to the issues raised in this letter as clearly as you can! Thanks.

[Kevin Pho, MD]

Any type of genitourinary infection can lead to neutrophils in the semen.  This can include a UTI or prostatitis.  There is no clear data on fertility because of the neutrophils, however some smaller studies suggests that it may be possible.

Regarding the possibility of transmission, it would depend on what is causing the rise in neutrophils.  This can include a digital rectal exam, or transrectal ultrasound, to evaluate the prostate, as well as tests to evaluate for other infections such as gonorrhea, chlamydia or epididymitis.  

After appropriate treatment (i.e. possible antibiotics if a discrete cause is found), then you may want to repeat the semen analysis.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
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