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Farahani L, Tharakan T, Yap T, Ramsay JW, Jayasena CN, Minhas S. The semen microbiome and its impact on sperm function and male fertility: A systematic review and meta-analysis. Andrology 2020; 9:115-144. [PMID: 32794312 DOI: 10.1111/andr.12886] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/09/2020] [Accepted: 08/07/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Male factor is attributable in up to 50% of cases of infertility. In vitro studies demonstrate that bacteria can negatively impact sperm function. The use of next-generation sequencing techniques has provided a better understanding of the human microbiome, and dysbiosis has been reported to impact health. Evidence regarding the impact of the semen microbiome on sperm function and fertility remains conflicting. MATERIALS AND METHODS A systematic search was conducted in accordance with the Preferred Reporting Items for Reviews and Meta-analysis (PRISMA) statement. The databases MEDLINE, OVID and PubMed were searched to identify English language studies related to the identification of bacteria in the semen of infertile and fertile men, between 1992 and 2019. Fifty-five observational studies were included, with 51 299 subjects. We included studies identifying bacteria using next-generation sequencing, culture or polymerase chain reaction. RESULTS The semen microbiome was rich and diverse in both fertile and infertile men. Three NGS studies reported clustering of the seminal microbiome with a predominant species. Lactobacillus and Prevotella were dominant in respective clusters. Lactobacillus was associated with improvements in semen parameters. Prevotella appeared to exert a negative effect on sperm quality. Bacteriospermia negatively impacted sperm concentration and progressive motility, and DNA fragmentation index (DFI; MD: 3.518, 95% CI: 0.907 to 6.129, P = .008). There was an increased prevalence of ureaplasma urealyticum in infertile men (OR: 2.25, 95% CI: 1.47-3.46). Ureaplasma urealyticum negatively impacted concentration and morphology. There was no difference in the prevalence of chlamydia trachomatis between fertile and infertile men and no significant impact on semen parameters. Enterococcus faecalis negatively impacted total motility, and Mycoplasma hominis negatively impacted concentration, PM and morphology. DISCUSSION AND CONCLUSIONS Ureaplasma urealyticum, Enterococcus faecalis, Mycoplasma hominis and Prevotella negatively impact semen parameters, whereas Lactobacillus appears to protect sperm quality. These findings may facilitate the development of novel therapies (eg probiotics), although the evidence regarding the impact of the seminal microbiome on fertility is inconclusive and further studies are needed to investigate this association.
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Affiliation(s)
- Linda Farahani
- Department of Obstetrics and Gynaecology, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.,Section of Investigative Medicine, Faculty of Medicine, Imperial College London, London, UK
| | - Tharu Tharakan
- Section of Investigative Medicine, Faculty of Medicine, Imperial College London, London, UK.,Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Tet Yap
- Department of Urology, Guys and St, Thomas's NHS Foundation Trust, London, UK
| | - Jonathan W Ramsay
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.,Department of Andrology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Channa N Jayasena
- Section of Investigative Medicine, Faculty of Medicine, Imperial College London, London, UK.,Department of Andrology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Suks Minhas
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
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Dehghan Marvast L, Aflatoonian A, Talebi AR, Eley A, Pacey AA. Relationship between Chlamydia trachomatis and Mycoplasma genitalium infection and pregnancy rate and outcome in Iranian infertile couples. Andrologia 2016; 49. [PMID: 28032361 DOI: 10.1111/and.12747] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2016] [Indexed: 11/30/2022] Open
Abstract
The study was performed to investigate the prevalence of Chlamydia trachomatis and Mycoplasma genitalium in a population of infertile couples from Iran and how this relates to tubal factor infertility, pregnancy rate and outcome of pregnancy. Blood, semen and first-void urine samples were obtained from 250 infertile couples and 250 fertile women as a control. Infertile couples were followed up after 24 months to determine diagnosis, referral for assisted conception, any pregnancy and pregnancy outcome. Data were analysed with regard to the results of (i) serological analysis for specific antibodies to C. trachomatis in serum; (ii) the presence of C. trachomatis and M. genitaliumDNA in first-void urine; and (iii) in a semen sample of the male partner. Prevalence of C. trachomatis in our study population was comparable to other studies using similar methods and test specimens. No evidence of M. genitalium infection was found. Detection of C. trachomatis in one partner rarely correlated with infection in the other. The risk of tubal factor infertility and the probability of pregnancy and pregnancy outcome were unrelated to the results of serological tests for C. trachomatis antibodies or the presence of C. trachomatisDNA in first-void urine of both partners and in a semen sample provided by the male.
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Affiliation(s)
- L Dehghan Marvast
- Department of Human Metabolism, Academic Unit of Reproductive and Developmental Medicine, The University of Sheffield, Sheffield, UK
| | - A Aflatoonian
- Research and Clinical Centre for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - A R Talebi
- Research and Clinical Centre for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - A Eley
- Department of Infection and Immunity, University of Sheffield, Sheffield, UK
| | - A A Pacey
- Department of Human Metabolism, Academic Unit of Reproductive and Developmental Medicine, The University of Sheffield, Sheffield, UK
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Ouzounova-Raykova V, Rangelov S, Ouzounova I, Mitov I. Detection ofChlamydia trachomatis,Ureaplasma urealyticumandMycoplasma hominisin infertile Bulgarian men with multiplex real-time polymerase chain reaction. APMIS 2015; 123:586-8. [DOI: 10.1111/apm.12391] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 02/23/2015] [Indexed: 11/27/2022]
Affiliation(s)
| | - Simeon Rangelov
- Department of Andrology; University Hospital ‘Tsaritsa Yoanna’; Medical University-Sofia; Sofia Bulgaria
| | - Iordanka Ouzounova
- Department of Andrology; University Hospital ‘Tsaritsa Yoanna’; Medical University-Sofia; Sofia Bulgaria
| | - Ivan Mitov
- Department of Medical Microbiology; Medical University-Sofia; Sofia Bulgaria
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Samplaski MK, Bachir BG, Lo KC, Grober ED, Lau S, Jarvi KA. Cocaine Use in the Infertile Male Population: A Marker for Conditions Resulting in Subfertility. Curr Urol 2015. [PMID: 26195962 DOI: 10.1159/000365687] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION We sought to evaluate the incidence and effect of cocaine use in the infertile male population. MATERIALS AND METHODS Men presenting for fertility evaluation reporting cocaine usage were identified via prospectively collected database. Data were analyzed for usage patterns, reproductive history, associated drug use and medical conditions, hormonal and semen parameters. RESULTS Thirty-eight out of 4,400 (0.9%) men reported cocaine use. Most used cocaine every 3 months or less. Compared with non-cocaine using men, cocaine users reported more recreational drug use (89 vs. 9.2%), marijuana use (78.9 vs. 11.4%), chlamydia (10.5 vs. 3%), herpes (7.9 vs. 2.5%), and tobacco use (55.3 vs. 19.5%). After excluding men with causes for azoospermia, the mean semen parameters for cocaine users were: volume 2.47 ± 1.02 ml; concentration 53.55 ± 84.04 × 10(6)/ml; motility 15.72 ± 12.26%; total motile sperm count 76.67 ± 180.30 × 10(6). CONCLUSIONS Few (< 1%) men in our infertile population reported the use of cocaine, and the frequency of use was low. Given the low use rates and limitations of reporting bias, it is difficult to determine the direct effect of cocaine use on male fertility. However, while infrequent cocaine use seems to have limited impact on semen parameters, men reporting cocaine use represent a different cohort of men than the overall infertile population, with higher rates of concurrent substance abuse, tobacco use and infections, all of which may negatively impact their fertility. Reported cocaine users should be screened for concurrent drug use and infections.
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Affiliation(s)
- Mary K Samplaski
- Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada
| | - Bassel G Bachir
- Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada
| | - Kirk C Lo
- Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada ; Faculty of Medicine, Institute of Medical Science, University of Toronto, Ontario, Canada
| | - Ethan D Grober
- Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada
| | - Susan Lau
- Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada
| | - Keith A Jarvi
- Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada ; Faculty of Medicine, Institute of Medical Science, University of Toronto, Ontario, Canada ; Lunenfeld Tannenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
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Plecko V, Zele-Starcevic L, Tripkovic V, Skerlev M, Ljubojevic S, Plesko S, Marekovic I, Jensen JS. Unusually low prevalence of Mycoplasma genitalium in urine samples from infertile men and healthy controls: a prevalence study. BMJ Open 2014; 4:e005372. [PMID: 25157184 PMCID: PMC4156801 DOI: 10.1136/bmjopen-2014-005372] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To detect Mycoplasma genitalium in urine samples of infertile men and men without any signs of infection in order to investigate whether M. genitalium and other genital mycoplasmas (Mycoplasma hominis and Ureaplasma spp) are found more often in urine samples of infertile men than in asymptomatic controls and to determine resistance to macrolides. METHODS The study included first void urine samples taken from 145 infertile men and 49 men with no symptoms of urethritis. M. genitalium, Chlamydia trachomatis and Neisseria gonorrhoeae were detected by commercial PCR. Trichomonas vaginalis was detected by microscopy and culture. M. hominis and Ureaplasma spp were detected by culture. M. genitalium was detected by in-house conventional and real-time PCR. RESULTS Two M. genitalium positive samples were found among samples obtained from infertile men. All asymptomatic men were M. genitalium negative. Macrolide resistance was not found in either of the two positive samples. CONCLUSIONS In comparison with reported data, an unusually low prevalence of M. genitalium was found in infertile men. The reasons for this unexpected result are not known; possibly, local demographic and social characteristics of the population influenced the result. Further studies to investigate M. genitalium in infertile and other groups of patients are needed.
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Affiliation(s)
- Vanda Plecko
- Department of Clinical and Molecular Microbiology, Clinical Hospital Centre Zagreb and School of Medicine University of Zagreb, Zagreb, Croatia
| | - Lidija Zele-Starcevic
- Department of Clinical and Molecular Microbiology, Clinical Hospital Centre Zagreb and School of Medicine University of Zagreb, Zagreb, Croatia
| | - Vesna Tripkovic
- Department of Clinical and Molecular Microbiology, Clinical Hospital Centre Zagreb and School of Medicine University of Zagreb, Zagreb, Croatia
| | - Mihael Skerlev
- Department of Dermatology and Venerology, Clinical Hospital Centre Zagreb and School of Medicine University of Zagreb, Zagreb, Croatia
| | - Suzana Ljubojevic
- Department of Dermatology and Venerology, Clinical Hospital Centre Zagreb and School of Medicine University of Zagreb, Zagreb, Croatia
| | - Sanja Plesko
- Department of Clinical and Molecular Microbiology, Clinical Hospital Centre Zagreb and School of Medicine University of Zagreb, Zagreb, Croatia
| | - Ivana Marekovic
- Department of Clinical and Molecular Microbiology, Clinical Hospital Centre Zagreb and School of Medicine University of Zagreb, Zagreb, Croatia
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Sellami H, Znazen A, Sellami A, Mnif H, Louati N, Zarrouk SB, Keskes L, Rebai T, Gdoura R, Hammami A. Molecular detection of Chlamydia trachomatis and other sexually transmitted bacteria in semen of male partners of infertile couples in Tunisia: the effect on semen parameters and spermatozoa apoptosis markers. PLoS One 2014; 9:e98903. [PMID: 25019616 PMCID: PMC4096407 DOI: 10.1371/journal.pone.0098903] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 05/08/2014] [Indexed: 11/19/2022] Open
Abstract
This study was undertaken to determine the prevalence of Chlamydia trachomatis, Mycoplasmas, and Ureaplasmas in semen samples of the male partners of infertile couples and to investigate whether Chlamydia trachomatis could initiate apoptosis in human spermatozoa. A total of 85 males partners of infertile couples undergoing routine semen analysis according to World Health Organization guidelines were included. Specimens were examined for the presence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum and Ureaplasma parvum by Real time PCR (qPCR). Semen specimens were analysed for the appearance of apoptotic markers (sperm DNA fragmentation, activated caspase 3 levels, mitochondrial membrane potential (ΔΨm)) using flow cytometry. C. trachomatis, N. gonorrhoeae, U. urealyticum, M genitalium were detected in semen samples of 13 (15.2%), 5 (5.8%), 5 (5.8%) and 3 (3.5%) male partners of infertile couples, respectively. M. hominis and U. parvum were detected in semen sample of only one patient (1.1%). The semen of infertile men positive for C. trachomatis showed lower mean of semen count and lower rapid progressive motility (category [a]) of spermatozoa compared to uninfected men with statistically significances (p = 0.02 and p = 0.04, respectively). Flow cytometry analyses demonstrated a significant increase of the mean rate of semen with low ΔΨm and caspase 3 activation of infertile men positive for C. trachomatis compared to uninfected men (p = 0.006 and p = 0.001, respectively). DNA fragmentation was also increased in sperm of infertile men positive for C. trachomatis compared to uninfected men but without statistical significances (p = 0.62). Chlamydial infection was associated to loss of ΔΨm and caspase 3activation. Thus, C. trachomatis infection could be incriminated in apoptosis induction of spermatozoa. These effects may explain the negative direct impact of C. trachomatis infection on sperm fertilizing ability.
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Affiliation(s)
- Hanen Sellami
- Department of Microbiology and research laboratory “Microorganismes et Pathologies Humaines”, Habib Bourguiba University Hospital of Sfax, Sfax, Tunisia
| | - Abir Znazen
- Department of Microbiology and research laboratory “Microorganismes et Pathologies Humaines”, Habib Bourguiba University Hospital of Sfax, Sfax, Tunisia
| | - Afifa Sellami
- Histology Embryology Research Unit, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Hela Mnif
- Sfax Regional Center of Blood Transfusion, Sfax, Tunisia
| | - Nour Louati
- Sfax Regional Center of Blood Transfusion, Sfax, Tunisia
| | - Soumaya Ben Zarrouk
- Histology Embryology Research Unit, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Leila Keskes
- Histology Embryology Research Unit, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Tarek Rebai
- Histology Embryology Research Unit, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Radhouane Gdoura
- Unit Research of Toxicology-Microbiology Environmental and Health, Sciences Faculty of Sfax, University of Sfax, Sfax, Tunisia
| | - Adnene Hammami
- Department of Microbiology and research laboratory “Microorganismes et Pathologies Humaines”, Habib Bourguiba University Hospital of Sfax, Sfax, Tunisia
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Molecular detection of potential sexually transmitted pathogens in semen and urine specimens of infertile and fertile males. Diagn Microbiol Infect Dis 2013; 77:283-6. [DOI: 10.1016/j.diagmicrobio.2013.05.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 04/10/2013] [Accepted: 05/31/2013] [Indexed: 11/19/2022]
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Abstract
This article provides an overview of infectious and inflammatory conditions associated with male infertility. These conditions may affect several components of the male reproductive tract and therefore have the ability to potentially alter sperm function. The effect of these conditions on male fertility is poorly understood and often underestimated.
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