Your Semen Analysis: White Blood Cell Concentration

What is a white blood cell and why does your semen analysis measure white blood cell concentration? If sperm cells are the quarterbacks of baby-making, white blood cells are like your offensive linemen.

What is a white blood cell and why does your semen analysis measure white blood cell concentration? If sperm cells are the quarterbacks of baby-making, white blood cells are like your offensive linemen. White blood cells (known in the medical industry as leukocytes or pus cells) are produced in your bone marrow. When there’s an infection, your brain signals yours white blood cells to go the site of infection and destroy the bacteria and prevent it from spreading through the rest of your body. This means that in areas where an infection may be present, there is a higher amount of white blood cells.

Counting Cells

In a typical semen analysis, a trained technician will take a sample of semen, place it on a slide and analyze the amount of cells and their quality. This can be tricky with white blood cells because of their shape. In a typical semen sample, there are some sperm cells that aren’t fully formed or that have been damaged, leaving only the rounded head of the sperm. In that same sample, there will probably be a few white blood cells, which are also round. The similarities between these cells means that the typical semen analysis technique won’t work for counting your white blood cells. To analyze the amount of white blood cells in a sample, a trained technician will typically use a staining technique, meaning that  a dye is applied to the sample, staining the white blood cells, making it easier for the technician to differentiate between the sperm cells and white blood cells.

Leukocytospermia

Leukocytospermia, also known as Pyospermia, is a condition in which your semen has an abnormally high amount of white blood cells. According to the World Health Organization,  an abnormally high amount of white blood cells is defined as 1 million cells per milliliter or higher. Roughly 5% of men with a fertility problem have leukocytospermia. Several things can cause leukocytospermia, including:

Infrequent ejaculation: White blood cells naturally accumulate over time, so the amount of white blood cells that your sample contains increases as time between ejaculations increases, which could lead to an abnormally high amount of blood cells in your semen

Autoimmune diseases: Autoimmune diseases occur when the body thinks that healthy cells are actually foreign, causing white blood cells to begin attacking these cells, including sperm cells.

A cold: If you’ve been sick in the past three months, your body’s production of white blood cells has increased, causing a higher amount to be present in your semen. .

An infection: If you’ve got an STI (sexually transmitted infection), your body sends white blood cells to the area of infection (your genitals) to fight it off the bacteria, leading to a spike of white blood cells.

How does Leukocytospermia affect your fertility?

Just like sperm cells, white blood cells produce a waste call reactive oxygen species (ROS). ROS destroys cells, both the bad cells (like bacteria) and the good cells (like sperm cells). Excessively high amounts of white blood cells in your semen are also indicative of an STI, which can cause blockage in the epididymis, preventing sperm from being released during ejaculation.

What’s Normal?

When it comes to white blood cells in your semen, the fewer the better. That being said, it’s okay to have some white blood cells in your semen. The WHO defines the normal white blood cell concentration is anything less than 1 million per cc. If your semen analysis shows a WBC of 1 million/cc or higher, your doctor will probably request more tests to investigate the cause of the white blood cells. The upside to having a high amount of leukocytes is that it’s very treatable once the cause has been identified.

47 thoughts on “Your Semen Analysis: White Blood Cell Concentration”

  1. What can you say about this result colour; creamy white, volume; 4.5 viscosity; moderate consistency; uniform. % motility 40% cells count 15*1000000/ml % of sluggishly motile 15% % of dead cells 55% morphology; normal cell 20% large oval head 30% small oval head 20% amorphous head 5% tail defect 10% immature cells 15% others Epith cells (+ ) WBC 8 10 hphf

  2. Hi Sara! 🙂

    My semenalysis result was this:
    Color: Pearly-white
    Odor: chlorox like
    Volume: 2.4
    Viscosity: viscous
    Liquifaction: 9 min
    Sperm count: 17,500,000/mL

    Motility
    Rapid progressive 80%
    Non progressive 10%
    Immotile 10%

    Wbc 10-12 /HPF
    rbc 0 /HPF

    Morphology
    Normal forms 95%
    Abnormal 5%

    -does my wbc normal? Or should I be worried about it? When we consulted it to a uroligists, he precribed an antibiotic for the next 30 days (2x a day) then after i should try again semenalysis before he will give his final diagnosis.

    1. It looks a little high but the value varies from lab to lab based on the method they use. So, I can’t comment too well on this value. I would recommend asking the lab.

      Because the urologist prescribed an antibiotic, he assumes there is a urinary or reproductive tract infection. I would recommend completing the complete course of antibiotics and then getting re-tested with a semen analysis in a month or two after everything is cleared up.

      I’m happy to review the next results after the antibiotics are complete.

  3. My semen analysis came up as following:

    Consistency is normal
    Color is opaque gray
    Volume is 5ml
    Liquefaction time is 30 minutes
    PH is alkaline 7.5
    Total sperm count is 83.5 millions per ml
    Motility within hour
    Progressive 55%
    Non progressive 10%
    Non motile 35%

    Morphology
    Normal is 70%
    Pin head is 10%
    Double head is 10%
    Others is 10%
    WBCs is 8-10/HPF
    RBCs is 0-1 /HPf
    Epithelial cells are rare.

    So what should I do
    Shall I worry for the HIGH WBCs

    1. probably not. You can ask the lab or your doctor to get evaluated for potential infection. Sometimes they can be a little high if you had a recent illness, injury or sometimes even for no reason at all, but it could be worth looking at if the lab said it was high.

  4. Hi my husband semenalysis result is this:
    Liquefaction time:minutes
    Color:yellowish white
    Viscous
    Motility:10%
    Morphology:70%
    Pus cells :3-4/hpf
    Red blood cells:2-3/hpf
    Sperm count:1,200,000 /ejaculate
    We’ve been trying to conceive for 11 years already.this always his result if he will not drink food supplement which is so expensive

  5. Hello, I have a question about our recent semen analysis. All areas came back with great results except for Round cells. It says normal is 5 and under his numbers were 5-7. There is a side note that states ” out of 100 round cells 2% were pmns, 31% were immature sperm cells and 67% were cytoplasts. what could this mean? We have an appointment May 22nd with Urology but I cant find much info online about this situation nor does my OB/GYN know what it means.

    1. Round cells can be white blood cells, immature sperm or other types of cells in the semen.
      Because normal is under 5 and his were over 5, they did a deeper investigation to what they were.
      If white blood cells is over 5 it can mean infection. In this case, its not white blood cells… it’s mostly immature sperm and pieces of sperm. So it’s not too concerning.

      Does that help clarify?

  6. Hello, my wife took the call from the doc for my semen analysis results and (language barrier) all she got was ‘normal / good’!

    I’m delighted to hear that as for the past 4 nights I haven’t slept after doing a home fertility test which came back negative! I’d really appreciate some feedback on my results though if you don’t mind including if the WBC count is ok. Thanks in advance

    Volume 3.6
    Colour – grayish white
    Liquidification – < 30 mins
    Viscosity – normal
    Ph – 8
    Sperm count – 89
    Sperm count ejaculate – 320
    Motility 1/2 hr –
    A 30
    B 30
    C 20
    D 20
    Ab of head 11
    Ab of neck 5
    Ab of tail 5
    Total number of normal % – 79
    Total number of abnormal % – 21
    WBC – 2-5

    1. I agree with the finding that this is a pretty normal semen analysis result. Volume is dead average. Count is slightly higher than average. Motility slightly lower than average. Normal is dead average.

      WBC is a little elevated. This can happen for several reasons — recent illness or injury, UTI or other urological infection. Sometimes it can be for no reason at all. If you are concerned you could definitely touch base with a urologist office to see if you should come in.

  7. Leuecocytes is 3-4 hpf is normal or not and aggregation of sperm is present it dengerous or not

  8. Hi, Sara .

    I am trying now for 5 months. I did the test again but now I did wait for 4 days instead of 24 hours. And the test was in the city instead of village.

    55 million/’ll
    30 % showing normal motility and morphology
    25 % sluggish motile
    45 % defective/dead motile
    Agglutination +
    Viscosity +
    Pus cells 4-5 hpf

    I did visit then a urogolist and he said only dead should be a little less but everything is within limits and I can pregnant my wife naturally.

    Is this so? What do you think honestly?

    1. I think you are healthy. These number looked pretty good.
      I would recommend that you try for 3-4 more months and if still no result, test again.

      Has your wife been to the doctor on her side?

  9. Hi, Sara. How are you? I am here in a foreign country and can’t consult my doctor in Netherland. What a great way to ask a question. I hope u will answer me as I am very tensed and nervous.

    I did my semen analyse and worried if my wife will be naturally pregnant.

    Volume 3.5 no
    Total count 30 million per cmm (cubic mm)
    Active motile 15%
    Slightly motile 20%
    Puss cells 20-30 hpf
    Viscosity: thin

    I can’t remember any STD or any infection. How is the report and is the puss treatable and can I get my wife naturally pregnant. The lab person says just 10 % chance to conceive.

    1. Hi Raja,

      I know this can feel scary. How long have you been trying to get pregnant with your wife?

      This results is on the lower side, but I don’t think it’s too bad. I also think that you can do some things to help improve your sperm count.
      Here is a list of steps that you can take to try to increase sperm.

      Regarding the puss cells, I can’t comment on this. Each lab has a different reference value for normal. You should ask the lab if they think it is high.
      If it is, there may be an infection that can easily be treated with antibiotics. But you would need to go to the doctor and get an evaluation for that.

  10. How to detect that, I have leukocytospermia or not, ,,in which test ,and what is the name of the test

  11. Hi Sara,

    I’ve been following these for a while and I notice that people don’t say this enough… thank you. The support you give is phenomenal.

    I had a question on high round cells. My results are below but ultimately the question is should I be overly concerned? Can I have the odd infrequent hot bath (helps with my marathon training).

    I’ve been tested for all relevant GTI That could Be provides (negative/clear on all) so I suspect a flu:cold or higher immature Sperm.

    We’re trying to conceive naturally.

    Vol:1.9ml
    Ph:8.5
    Concentration: 182.2Mml-1
    Total count: 349.9m
    Motility: A49% B17% C8% D26%
    Morph: 4.0
    Round cell: 6.2Mml-1

    I’ll go back for another test but very keen to see your thoughts?

    Thank you so much again.

    1. Thank Michael! I really appreciate it. It’s something I love to do!

      Your numbers look fantastic. I wouldn’t fret over an occasional dip in the tub. I would keep the time short or come out at regular frequency.
      Actually, you could get some cooling underwear and use them just after a dip and probably sky rocket your numbers. (Some experiments in the 60s that alternated heat with cooling showed some incredible results on sperm). White cells are elevated but not so much that I’m overly worried. I think your guess is probably spot on.

      Morph is a little lower than I’d like to see but most current literature really doesn’t find much value in morph esp when counts are high.

      I’d recommend keeping a tab on things. Over training can strain the reproductive system so just don’t overdo it. Your body should start sending you signs if you are overtraining.

      Happy to answer any other questions that come up. Also… Would you mind if I copy this post into the new forum that I’m working on launching. I’d like to help connect more guys who are going through this kind of stuff with each other to increase dialog. There is so much we don’t know about sperm and men generally don’t have too much support when starting their family or dealing with fertility issues and I’d like to change both of those things if I can.

        1. Thanks. Here’s a link to the post if you want to follow up on the discussion.
          It is also much easier for me to follow threads there and keep the history straight 🙂

          Good luck with everything!

    2. Hello Michael, curious how things came back with the round cells, my husband had similar results. waiting for our appointment with the urologist

  12. I recently Received my Report

    Liquification time= YES
    Microscopic Examination:
    Total count= <0.01 mil/ml
    WBC = 9/HPF
    Progression: 0%
    Rapidly Motile: QNS
    Sluggish Motile: QNS
    Non Motile: QNS
    motility: 0%
    mean linear Velocity : Visual Motility UM

    I did a semen culture for the same sample and the result is " no growth"
    there is no infection

    Why I have high WBC?
    Thanks fr your help

    1. From other reports that have been posted, this doesn’t look terribly high for white blood cells. However, HPF varies from lab to lab so it is a little difficult to give you good feedback. So you should ask your lab what the reference range is. You may also want to visit a urologist for additional testing.

        1. So, it is not too far above the range. Sometimes this indicates infection, recent surgery, illness (like a cold) or sometimes it is for no reason at all. Have you been sick recently?

    1. It means there are some white blood cells in your sample. I cannot tell from this comment if there are more than usual.

  13. Hi..here my microscopic examination
    Ph- 8.00
    Volume – 3.0
    Appearance- yellowish viscid
    Motility(at 2 hour) – 40%
    Sperm count – 33 x10^6/ml
    Total no of sperms- 99
    Morphology- 50%
    Rbc- 1-2/hpf
    Wbc- 1-2 /hpf
    Most of the result on doubtful range
    May I able to having child since my semen analysis was very bad..

    1. It wasn’t very bad. It was lower than I like to see and it may take you a while to get pregnant but I think it is very possible.
      If you would like to try to improve there are usually things that men can do to make their sperm healthier.

      Here is an article with the top 20 things you can do. If you’d like to get a more personal list of recommendations you can download this app and fill out the health questionnaire.

  14. My White Blood Cells count shows 55 Million/ml….does that mean 55 millions WBC? Isn’t that dangerous? Or am I misreading the Test?

    1. Hi John, I believe that we spoke yesterday. If not, my recommendation would be to follow up with a urologist to see what they recommend. High WBCs tend to suggest that there may be an infection somewhere in the reproductive tract, but they can occur for other reasons. Sometimes for no reason at all. But it is best to check with the doctor and see what they suggest.

  15. Wbc is 4-5 and count show 0. Can u please tell me what is the reason.

    Previouslt count is less than 2 million and wbc is 1-2

  16. I recently Received my Report and it says kindly interpret it for me and give me hopeful response..
    PH=8
    Liquification time= 30 min
    Microscopic Examination:
    Total count= 30 mil/ml
    WBC = >20/HPF
    Motility:
    Rapidly Motile: 15
    Sluggish Motile: 20
    Non Motile: 65
    Morphology:
    Normal: 10 %
    Abnormal: 90 %
    Kindly let me know is it Treatable and can i have child ?

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