Q. Pus cells are evident in my semen analysis report. Kindly interpret my report.

Answered by
Dr. Dattaprasad Balasaheb Inamdar
and medically reviewed by iCliniq medical review team.
Published on Dec 12, 2019

Hello doctor,

My semen analysis shows:

Sperm Count - 98 millions/ml,

Liquefaction time - 25 minutes,

Reaction - alkaline.

Motility: active - 70%, slugglish - 10%, non-motile - 20%.

Morphology: Normal forms - 92%, abnormal forms - 8%.

Other findings: Pus Cells 40-45/HPF.

Semen culture also shows no growth. Please tell me the appropriate medicine.

Dr. Dattaprasad Balasaheb Inamdar

Infertility Obstetrics And Gynaecology
#

Hi,

Welcome to icliniq.com.

If you do not have symptoms of urinary infection like burning, frequency of urination, blood in urine or semen, you need not take any medicines. Immature sperms also appear like pus cells on microscopy.

One good option is to repeat the semen analysis after one week. Do not keep abstinence from more than two to three days before the next analysis. If pus cells are again seen in the high count, we may have to repeat semen culture for routine bacteria, as well as tuberculous bacilli and then decide accordingly. If you have any of the symptoms described above, you can repeat semen culture once more and take antibiotics accordingly.

I hope this helps.

Thank you doctor,

I am doing semen analysis every two months from the last one year. Every time pus cells are there. No other symptoms present other than increased urinary frequency. I keep abstinence of two days for every analysis.

Dr. Dattaprasad Balasaheb Inamdar

Infertility Obstetrics And Gynaecology
#

Hi,

Welcome back to icliniq.com.

If this was the first time you did semen culture, you can repeat it once more from any standard laboratory. If it is already done more than once and no growth was obtained all the time, you need to do a leucocyte esterase test. This test will tell whether cells seen in semen are real pus cells and not immature sperms (both look the same under a microscope).

If two semen cultures show no growth and leucocyte esterase test is positive, it indicates chronic infection either chlamydia or tuberculosis. To confirm the same, a culture of prostatic massage fluid can be done. The urologist can do it for you. Kindly follow the plan advised above for the cure of infection if it is present. You can consult a urologist for the same.

I hope this helps.

Thank you doctor,

My wife is also feeling itching in the outer vaginal area. Should I go for the LE test for her also? How can I know whether she is having an infection?

Dr. Dattaprasad Balasaheb Inamdar

Infertility Obstetrics And Gynaecology
#

Hi,

Welcome back to icliniq.com.

Itching around the vagina in women is generally due to either a fungal infection or allergic dermatitis. The gynecologist can examine it, differentiate between two and treat the same. Treatment of two conditions is different, so correct diagnosis is essential.

Regarding leucocyte peroxidase test (not leucocyte esterase, sorry for that), the test differentiates immature sperms from pus cells, so no use in women. If your wife has an infection, you both need to take treatment for the same simultaneously to eradicate the infection completely. If any of your reports suggests infection (leucocyte peroxidase positive cells > one million/mL and/or positive semen culture), you need to take a long course of antibiotics of three to six weeks (and not just 3-5 days which is normally given).

If the culture comes positive for staphylococcus, kindly take second or third opinion before starting antibiotics as it is normally a contaminant and rarely due to infection.

I hope this helps.

Thank you doctor,

My wife was having herpes zoster eight months back. She took antibiotics and recovered. She is often suffering from itching for the last two years. We are planning a baby from the last 18 months but not successful. What tests we should perform to determine the kind of problem?

Dr. Dattaprasad Balasaheb Inamdar

Infertility Obstetrics And Gynaecology
#

Hi,

Welcome back to icliniq.com.

Three basic things required for conception are normal sperm count, patent tubes (wife) and regular ovulation (wife).

As far as the information you have given, your sperm count and motility are normal. I do not know about the other two variables. Kindly give the following basic information for further guidance:

Wife's age? Whether your wife's menses are regular? How is the frequency of the cycle? (eg. menses coming for every 28-30 days and the flow lasting for 3-4 days). Whether any tubal patency test like HSG (hysterosalpingography), SSG (sonosalpingography), laparoscopy was done? If yes, what was the result? What treatment have you taken till now?

Kindly get back with the information.

Thank you doctor,

My wife's age is 27. Menses are regular. Menstrual cycle is of 28 days. Her flow lasts for three to four days. Any kind of tubal patency test was not done.

Tablet Albendazole 400 mg for one day and tablet Orafer two times a day for 30 days given to my wife 10 months before.

Tablet Doxy 100 mg once daily for 21 days was also given to me at that time. We also do BBT charting, as per BBT, ovulation occurs on 13-14th day.

Dr. Dattaprasad Balasaheb Inamdar

Infertility Obstetrics And Gynaecology
#

Hi,

Welcome back to icliniq.com.

Just do one HSG (hysterosalpingography) for your wife. It is done to check patency of tubes, generally within the first 10 days of starting menses. Stop doing BBT. Predicting ovulation is not going to help, it will just increase your anxiety. In any case, if cycles are regular of 28 days, ovulation should occur on the 14th day.

One general advice is not to restrict intercourse around ovulation. You can have intercourse two to three times a week irrespective of ovulation day. Try daily if possible between day 10 - 18 of the cycle (day of the start of menses is considered as day one). If tubes are patent on HSG, you can safely try naturally for another three to six months without any monitoring and without taking any medicine (wife can take folic acid tablets). This should reduce your anxiety and help in conception.

If pregnancy does not occur in another six months, we will decide further course of action. Meanwhile, you can get evaluated for seminal infection and get treatment if infection is present.

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