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Abstract 20

Chronic Pelvic Pain Syndrome (CPPS): Impact of Inflammation on Fertility Parameters with Special Focus on Computer-Assisted Motility Analysis and Morphology

M Ludwig,1 A Vidal,1 I Schroeder-Printzen,1 W Pabst,2, W Weidner1

Department of Urology and 2Institute of Medical Statistics, Justus-Liebig University, Giessen, Germany

Introduction The impact of defined urogenital inflammations on male fertility is still a matter of controversial debate. We analyzed classical fertility parameters in patients with inflammatory versus non-inflammatory CPPS (NIH IIIA/IIIB) and refined motility analysis by using objective motility parameters generated by computer-assisted sperm analysis.

Material and Methods One hundred and twelve (112) consecutive patients (pts.) with a Giessen prostatitis symptom score 28 were included. All pts underwent "the four glass-test" including leukocyte determination in expressed prostatic secretions (EPS) and identical aliquots of first urine, midstream urine, and urine after prostatic massage (VB3). Patients with 210 leukocytes in EPS (1000x), 210 in VB3 (400x), or 21 mill/ml peroxidase positive leukocytes (PPL) in ejaculate were considered NIH Illa. Patients with bacterial prostatitis were excluded. Spermiogram analysis was done according to WHO and, besides PPL, included pH, volume, total sperm count, sperm density, motility (WHO a-d), morphology (Shorr stain), and vitality (eosin stain). Additionally, modality of sperm motion was evaluated by computer-assisted sperm analysis: velocity straight line (VSL), velocity curvilinear (VCL), velocity average path (VAP), linearity (VSL/ VCL), and straightness (VSL/VAP). Statistical analysis included Mann-Whitney U-test and Wilcoxon rank sum test.

Results Sixty-seven (67) patients demonstrated increased leukocytes in EPS and/or VB 3 and/or ejaculate (NIH IIIa), whereas 45 patients did not (NIH IIIb). Neither any of the spermiogram nor modality of motion parameters demonstrated any significant difference between NIH Illa and NIH IIIb patients.

Conclusions Routine ejaculate parameters and objective computer-assisted sperm motion analysis do not register an effect of inflammation to male fertility. Evaluation of sperm function may be one way to detect a possible role of inflammation in male subfertility.