Male infertility affects millions worldwide, yet its underlying causes remain incompletely understood. Total round cell concentration (TRCC) in semen, particularly leukocytospermia, has been suggested as a biomarker of impaired sperm function. However, its relationship with sperm DNA fragmentation index (DFI) remains unclear, particularly in sub-Saharan Africa, where research is scarce. This study examines the prevalence of elevated TRCC and its associations with semen parameters and sperm DNA fragmentation among men attending a fertility clinic in Kumasi, Ghana. A cross-sectional study was conducted among 227 men, with semen samples analyzed following WHO guidelines. Sperm concentration, motility, and morphology were assessed, while TRCC was quantified using a Neubauer hemocytometer and light microscopy. Sperm DNA fragmentation was determined using the Sperm Chromatin Structure Assay, and multivariate logistic regression models were employed to evaluate associations between TRCC and semen quality parameters. Elevated TRCC was detected in 19.4% of participants. Higher TRCC levels were significantly associated with lower odds of oligozoospermia (c OR = 0.30; 95% CI [0.20, 0.92]; p = .030), a relationship that remained significant after adjusting for confounders (a OR = 0.18; 95% CI [0.05, 0.67]; p = .010). However, TRCC was not significantly associated with asthenozoospermia ( p = .656) or teratozoospermia ( p = .592). Additionally, no correlation was observed between TRCC and sperm DFI ( r = .009, p = .958). It can therefore be concluded that the presence of round cells in semen does not influence sperm DNA integrity.

Background: Male infertility is a growing reproductive health concern in Ghana, contributing significantly to the burden of infertility among couples. Bacteriospermia, the presence of bacteria in semen, has been implicated in male infertility through its potential adverse effects on sperm quality; however, its association with semen parameters remains inconsistent across studies. This study aimed to determine the prevalence of bacteriospermia and examine its association with semen parameters among males attending a fertility clinic in Kumasi, Ghana. Materials and methods: Semen samples from 226 males attending a fertility hospital in Kumasi were collected and evaluated according to WHO guidelines. Additionally, samples were cultured for bacteria using standard bacterial culture techniques. Results: The prevalence of bacteriospermia was 46.5%, with Escherichia coli (41.9%), Klebsiella spp. (25.7%), Staphylococcus spp. (24.8%), Streptococcus spp. (2.9%), and Bacillus spp. (1.9%) identified. Abnormal semen parameters were observed in 47.6% of participants, predominantly teratozoospermia. No significant association was found between bacteriospermia and semen parameters ( p > 0.05), though semen volume approached significance as a predictor of bacteriospermia ( p = 0.057), with hypospermia associated with significantly lower odds of bacteriospermia (aOR = 0.558; p = 0.047) and hyperspermia showing no significant association (aOR = 0.961; p = 0.160). Conclusions: A high prevalence of bacteriospermia (46.5%) and abnormal semen parameters (47.6%, predominantly teratozoospermia) were observed among men seeking fertility evaluation, with E. coli as the most frequently isolated organism. No significant association was found between bacteriospermia and semen parameters, though hypospermia was associated with significantly lower odds of bacteriospermia. Routine screening and further research incorporating molecular techniques and larger cohorts are recommended.