Association of leukocyte elastase in semen and seminal plasma with sperm parameters and pregnancy outcomes in male fertility
Background Semen analysis is the standard test for evaluating male fertility. However, it may not address all aspects of male infertility. This review explores the role of leukocyte elastase (LE) as a possible biomarker for male fertility by evaluating 28 corresponding studies. Objectives We aimed to explore how LE levels in semen relate to sperm quality and pregnancy outcomes. Methods This systematic review followed PRISMA guidelines and included studies from PubMed, Medline, Embase and Scopus (March 22–25, 2024) using the keywords ‘elastase’, ‘sperm’ and ‘semen’. Out of 897 identified articles, 334 were screened, leading to 90 full-text reviews. We included 28 studies reporting sperm parameters linked to LE and excluded non-English articles, reviews and animal studies. Data collected included study details, methods, population, LE levels, sperm characteristics and pregnancy outcomes. A narrative synthesis was used because of differing study designs. Quality assessment, using the Nati
