Significance of semen cultures for men with questionable semen quality.

Semen cultures often yield inconclusive results probably due to bacterial contaminants. We were able to isolate enteric pathogens with greater specificity by comparing two cultures from the same individual: one obtained from the midstream urine and the other from ejaculate obtained following midstream urine collection and eliminating the bacteria present in the midstream urine. Bacterial growth was found in semen cultures from 102 (79%) of the 129 men with questionable semen quality; 31 (30%) had aerobic bacteria, 28 (27%) had anaerobic bacteria, and 43 (42%) had both. A high incidence of positive cultures in our study was probably due to stringent patient selection and our comparative culturing procedure. The presence of pathogens may indicate the need for treatment especially prior to IVF and IUI.