<s>[INST] Good evening sir, I have an infertile couple, and i wanna your openion in processing the male factor. 1st i asked the male to do semen analysis, i found almost all parameters are good except the pus cells ratio which was about 100 /HPF, then i asked for culture and senstivity to diagnose the causative organism for this infection, the lab had recommended giving this patient Ciprofloxacin so i gave it for 45 days and asked for another sample to detect the effectiveness of the treatment where i found that the pus cells count become more than 100/HPF ">100.000.000 /ml". i asked for another culture and sensitivity test to be done at other 2 labs, one of them recomended Septrin DS and the other said that no growth found on the culture in the sample. So, I have three different results from 3 different labs for the same person and i am afraid to try each result with my patient as the treatment coarse is usually long durated Clinical examination, U/S and doppler for both testes are irrelevant Thank you for cooperation [/INST] Hi, I have understood your dilemma. In fact pus cells found in the semen are many times misleading. Routine laboratories label them as pus cells on their size. We have found that many times the labelled pus cells really turned out to be immature sperms. It seems that this could be the problem in your case. Please get the semen examined from a specialist an Chat Doctor.  In case this turns out to be premature or immature sperms, you might have to get the male hormonal profile done - LF, Testosterone & CSH to decide on further plan of management. An </s>