Elevated Seminal pH and Ureaplasma Urealyticum

¹ Division of Urology, University of Rochester School of Medicine and Dentistry, Rochester, New York
² Division of Laboratories and Research, Department of Health, State of New York, Albany, New York

Normal semen has up to three polymorphonuclear leukocytes per high power field (HPF). Reduced zinc concentrations (<15 mg/dl), elevated pH (>7.7), and neutrophils (5-10 leukocytes/HPF) in semen can suggest the presence of an asymptomatic infection. Reduced zinc levels, pyosemia and elevated pH suggest prostatic secretory dysfunction. Fifty-seven patients with at least two of the above alterations underwent special urine and semen cultures in an attempt to isolate Ureaplasma (U.) urealyticum. Twenty-seven of the 57 semen cultures were positive for U. urealyticum. Patients with pyosemia, reduced seminal zinc, and elevated pH should be treated with antibiotics (usually minocycline) for a minimum of four weeks. Subsequent semen analysis should be monitored to gauge efficacy of treatment. We emphasize a clinical therapeutic approach based on the above parameters, in the absence of other demonstrable causes of infertility.

     Key words: Ureaplasma urealyticum, elevated seminal pH, pyosemia, minocycline

Submitted on April 14, 1981
Revised on June 22, 1981
Accepted on July 16, 1981