Effect of the Presence of Pus Cells in Seminal Fluid Samples on Sperm Motility and Morphology in a Group of Males Attended Subfertility Clinics in Galle District, Sri Lanka

Background: The quality of seminal fluid is one of the main determinants of male fertility. The quality of seminal fluid is determined by several parameters such as volume, sperm concentration, percentage of normal morphology, motility, viability, progressivity, etc. The objective of the study was to assess the effects of the presence of pus cells in seminal fluid samples on normal morphology and motility.

Methods: A cross-sectional study was conducted among a sample of 107 men who attended subfertility clinics in Galle district, Sri Lanka. Consecutive (convenience) sampling method was used. After obtaining the informed consent, semen samples were collected. Pus cell count, sperm motility and normal morphology were evaluated based on the WHO guidelines (2010). Ethical approval was obtained from the Ethics Review Committee, Faculty of Allied Health Sciences, University of Ruhuna.

Results: The majority of samples had pus cell count less than 5 per high power field (n=75, 70.1%). Only 32 (29.9%) had a pus cell count of 5 or above per high power field (/HPF). 32 samples (42.7%) out of 75 samples with pus cell count <5 (/HPF) had a percentage normal morphology of more than 30%, while only 3 samples (9.4%) with pus cell count ≥5 (/HPF) had a percentage normal morphology of more than 30%. The mean and standard deviation (SD) of normal morphology were 26.88% and 8.69% for samples with pus cell count <5 (/HPF) while 21.39% and 7.00% for samples with pus cell count ≥5 (/HPF). Z value was 3.124 and the level of significance was 0.05. Therefore, the finding was highly significant (p= 0.002). 32 samples (42.7%) out of 75 samples with pus cells <5 (/HPF)  had normal motility (≥50%). However, only 6 (19%) of 32 samples with pus cells ≥5 (/HPF) had normal motility (≥50%). The mean and standard deviation (SD) of normal motility were 46.32% and 11.30% for samples with pus cell count <5 (/HPF) while the mean and standard deviation (SD) of normal motility were 41.25% and 10.37% for samples with pus cell count ≥5 (/HPF). Z value was 3.124 and the level of significance was 0.05. Therefore the finding was highly significant (p = 0.032).

Conclusions: The obtained results demonstrated that the pus cell count can be a factor inversely associated with sperm morphology and motility.