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Collar AL, Clarke TN, Jamus AN, Frietze KM. Ensuring equity with pre-clinical planning for chlamydia vaccines. NPJ Vaccines 2023; 8:131. [PMID: 37673890 PMCID: PMC10482967 DOI: 10.1038/s41541-023-00726-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Abstract
Chlamydia trachomatis (Ct) remains the most common bacterial sexually transmitted pathogen worldwide, causing significant morbidity particularly among women, including pelvic inflammatory disease, ectopic pregnancy, and infertility. Several vaccines are advancing through pre-clinical and clinical development, and it is likely that one or more vaccines will progress into human efficacy trials soon. In this Perspective, we present a case for considering the challenges of Ct vaccine development through a lens of equity and justice. These challenges include the need to protect against multiple serovars, in both females and males, at multiple anatomic sites, and in resource poor areas of the world. We propose that early consideration of vaccine implementation by conducting community-engaged research will ensure that a scientifically sound chlamydia vaccine promotes equity, justice, and shared-gendered responsibility for STI prevention.
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Affiliation(s)
- Amanda L Collar
- Department of Molecular Genetics and Microbiology, School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Tegan N Clarke
- Department of Molecular Genetics and Microbiology, School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Andzoa N Jamus
- Department of Molecular Genetics and Microbiology, School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Kathryn M Frietze
- Department of Molecular Genetics and Microbiology, School of Medicine, University of New Mexico, Albuquerque, NM, USA.
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2
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Rivero MJ, Kulkarni N, Thirumavalavan N, Ramasamy R. Evaluation and management of male genital tract infections in the setting of male infertility: an updated review. Curr Opin Urol 2023; 33:180-186. [PMID: 36861760 PMCID: PMC10073322 DOI: 10.1097/mou.0000000000001081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
PURPOSE OF REVIEW Male infertility may be secondary to male genital tract infection (MGTI) in an estimated 15% of cases. In the absence of overt clinical signs, evaluation for MGTI beyond semen analysis is not well established. Therefore, we review the literature on the evaluation and management of MGTI in the setting of male infertility. RECENT FINDINGS A set of international guidelines recommends semen culture and PCR testing, but the significance of positive results remains unclear. Clinical trials evaluating anti-inflammatory or antibiotic treatment report improvements in sperm parameters and leukocytospermia, but data on the effect on conception rates are lacking. Human papillomavirus (HPV) and the novel coronavirus (SARS-CoV-2) have been associated with poor semen parameters and decreased conception rates. SUMMARY The finding of leukocytospermia on semen analysis prompts further evaluation for MGTI, including focused physical examination. The role of routine semen culture is controversial. Treatment options include anti-inflammatories; frequent ejaculation; and antibiotics, which should not be used in the absence of symptoms or microbiological infection. SARS-CoV-2 represents a subacute threat to fertility that should be screened for in the reproductive history along with HPV and other viruses.
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Affiliation(s)
- Marco-Jose Rivero
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL
- Case Western Reserve University School of Medicine, Cleveland, OH
| | - Nikhil Kulkarni
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Nannan Thirumavalavan
- Case Western Reserve University School of Medicine, Cleveland, OH
- Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL
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3
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Detection of Chlamydia trachomatis inside spermatozoa using flow cytometry: Effects of antibiotic treatment (before and after) on sperm count parameters. J Microbiol Methods 2022; 203:106604. [PMID: 36330892 DOI: 10.1016/j.mimet.2022.106604] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 11/07/2022]
Abstract
There is increasing evidence that Chlamydia trachomatis (CT) infection can directly affect male fertility. However, only few have investigated the effects of CT on semen parameters, and mostly with inconclusive results. The main aims of this study were to identify CT inside spermatozoa, and the possible pre and post antibiotic treatment effects on the overall semen parameters. We developed a flow cytometric method for the detection of CT inside spermatozoa (SPI™). Briefly, sperm cells were fixed, membrane permeabilized and DNA was loosened using DNAse. Sperm cells were incubated with a primary monoclonal antibody against CT and with a secondary fluorescent antibody (vs primary), and analysed using a flow cytometer. Of 2415 infertile individuals, 48.61% were found positive for CT. 170 CT+ samples were included in the CT antibiotic treatment study. 78.82% (134/170) of the CT+ showed a significant reduction in the percentage of the iCT infected spermatozoa after the antibiotic treatment; 59.70% (80/134) decreased to non-detectable levels. Spermcount data were also recorded. Spermatozoa morphology (normal and teratozoospermia index, TZI) and motility (fast progressive and non-progressive spermatozoa) were statistically significant altered in CT+ pre-treatment vs control group. CT antibiotic treatment showed statistically significant effects on normal spermatozoa morphology, mid-piece and tail defects, and TZI. The study demonstrated that semen flow cytometric analysis of semen could be a valuable tool for faster and accurate identification of individuals with asymptomatic CT infection. It also identified a positive effect of antibiotic therapy on semen parameters, that could help males with infertility.
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Tvrdá E, Ďuračka M, Benko F, Lukáč N. Bacteriospermia - A formidable player in male subfertility. Open Life Sci 2022; 17:1001-1029. [PMID: 36060647 PMCID: PMC9386612 DOI: 10.1515/biol-2022-0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/29/2022] [Accepted: 05/18/2022] [Indexed: 11/24/2022] Open
Abstract
Bacterial colonization of male reproductive tissues, cells, and fluids, and the subsequent impact of bacteria on the sperm architecture, activity, and fertilizing potential, has recently gained increased attention from the medical and scientific community. Current evidence strongly emphasizes the fact that the presence of bacteria in semen may have dire consequences on the resulting male fertility. Nevertheless, the molecular basis underlying bacteriospermia-associated suboptimal semen quality is sophisticated, multifactorial, and still needs further understanding. Bacterial adhesion and subsequent sperm agglutination and immobilization represent the most direct pathway of sperm-bacterial interactions. Furthermore, the release of bacterial toxins and leukocytic infiltration, associated with a massive outburst of reactive oxygen species, have been repeatedly associated with sperm dysfunction in bacteria-infested semen. This review serves as a summary of the present knowledge on bacteriospermia-associated male subfertility. Furthermore, we strived to outline the currently available methods for assessing bacterial profiles in semen and to outline the most promising strategies for the prevention and/or management of bacteriospermia in practice.
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Affiliation(s)
- Eva Tvrdá
- Department of Animal Physiology, Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, Nitra-Chrenová, 949 76, Slovakia
| | - Michal Ďuračka
- Department of Animal Physiology, Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, Nitra-Chrenová, 949 76, Slovakia
| | - Filip Benko
- Department of Animal Physiology, Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, Nitra-Chrenová, 949 76, Slovakia
| | - Norbert Lukáč
- Department of Animal Physiology, Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, Nitra-Chrenová, 949 76, Slovakia
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5
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Prokopev IV, Abdrakhmanov AR. Capabilities of combined peptide drugs in the correction of male infertility (literature review). CONSILIUM MEDICUM 2021. [DOI: 10.26442/20751753.2021.12.201295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Acute and chronic urogenital infections are associated with male infertility. Besides "traditional" sexually transmitted infections, there is a significant increase in inflammatory diseases of reproductive system caused by opportunistic pathogens. Studies show that sperm fertility is influenced by direct exposure to sexually transmitted infections, as well as dysfunction of the blood-testicular barrier, leading to autoimmune infertility. In a number of clinical trials, Prostatilen AC was shown to have benefitial effects on the ejaculate.
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Eini F, Kutenaei MA, Zareei F, Dastjerdi ZS, Shirzeyli MH, Salehi E. Effect of bacterial infection on sperm quality and DNA fragmentation in subfertile men with Leukocytospermia. BMC Mol Cell Biol 2021; 22:42. [PMID: 34388964 PMCID: PMC8364116 DOI: 10.1186/s12860-021-00380-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/05/2021] [Indexed: 11/21/2022] Open
Abstract
Background Although bacterial infections have been recognized as a possible cause of male infertility, the effect of bacterial infections on sperm quality and sperm DNA fragmentation remains controversial. The current study aimed to investigate the prevalence rate of bacterial infection in subfertile men and its effect on semen quality. Seminal fluid was collected from 172 male members of infertile couples attending the andrology infertility center and a group of 35 fertile subjects as a control. Sperm parameters and DNA fragmentation were evaluated based on the type of bacteria in all ejaculates. Results From the 172 patients investigated for infertility, 60 (34.88%) patients had a positive culture for pathogenic bacteria of different species. Leukocytospermia was significantly higher in infected samples in comparison with non-infected samples (p < 0.05). Sperm concentration and motility and morphology were significantly lower in infected than non-infected samples. Moreover, sperm DNA fragmentation was significantly higher in infected than non-infected samples. Besides, our results showed that sperm DNA fragmentation was correlated significantly with leukocytospermia (R: 0.22, p < 0.01). Conclusion The present study suggested that bacterial infection significantly correlated with leukocytospermia could impair male fertility potential through decreasing sperm motility, morphology, and DNA integrity.
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Affiliation(s)
- Fatemeh Eini
- Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Maryam Azizi Kutenaei
- Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Fayegheh Zareei
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | | | - Ensieh Salehi
- Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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7
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Bryan ER, McLachlan RI, Rombauts L, Katz DJ, Yazdani A, Bogoevski K, Chang C, Giles ML, Carey AJ, Armitage CW, Trim LK, McLaughlin EA, Beagley KW. Detection of chlamydia infection within human testicular biopsies. Hum Reprod 2020; 34:1891-1898. [PMID: 31586185 PMCID: PMC6810529 DOI: 10.1093/humrep/dez169] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 07/12/2019] [Indexed: 12/17/2022] Open
Abstract
STUDY QUESTION Can Chlamydia be found in the testes of infertile men? SUMMARY ANSWER Chlamydia can be found in 16.7% of fresh testicular biopsies and 45.3% of fixed testicular biopsies taken from a selection of infertile men. WHAT IS KNOWN ALREADY Male chlamydial infection has been understudied despite male and female infections occurring at similar rates. This is particularly true of asymptomatic infections, which occur in 50% of cases. Chlamydial infection has also been associated with increased sperm DNA damage and reduced male fertility. STUDY DESIGN, SIZE, DURATION We collected diagnostic (fixed, n = 100) and therapeutic (fresh, n = 18) human testicular biopsies during sperm recovery procedures from moderately to severely infertile men in a cross-sectional approach to sampling. PARTICIPANTS/MATERIALS, SETTING, METHODS The diagnostic and therapeutic biopsies were tested for Chlamydia-specific DNA and protein, using real-time PCR and immunohistochemical approaches, respectively. Serum samples matched to the fresh biopsies were also assayed for the presence of Chlamydia-specific antibodies using immunoblotting techniques. MAIN RESULTS AND THE ROLE OF CHANCE Chlamydial major outer membrane protein was detected in fixed biopsies at a rate of 45.3%. This was confirmed by detection of chlamydial DNA and TC0500 protein (replication marker). C. trachomatis DNA was detected in fresh biopsies at a rate of 16.7%, and the sera from each of these three positive patients contained C. trachomatis-specific antibodies. Overall, C. trachomatis-specific antibodies were detected in 72.2% of the serum samples from the patients providing fresh biopsies, although none of the patients were symptomatic nor had they reported a previous sexually transmitted infection diagnosis including Chlamydia. LIMITATIONS, REASONS FOR CAUTION No reproductively healthy male testicular biopsies were tested for the presence of Chlamydia DNA or proteins or Chlamydia-specific antibodies due to the unavailability of these samples. WIDER IMPLICATIONS FOR THE FINDINGS Application of Chlamydia-specific PCR and immunohistochemistry in this human male infertility context of testicular biopsies reveals evidence of a high prevalence of previously unrecognised infection, which may potentially have a pathogenic role in spermatogenic failure. STUDY FUNDING/COMPETING INTEREST(S) Funding for this project was provided by the Australian NHMRC under project grant number APP1062198. We also acknowledge assistance from the Monash IVF Group and Queensland Fertility Group in the collection of fresh biopsies, and the Monash Health and co-author McLachlan (declared equity interest) in retrieval and sectioning of fixed biopsies. E.M. declares an equity interest in the study due to financing of fixed biopsy sectioning. All other authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Emily R Bryan
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, 300 Herston Rd, Herston, QLD 4006, Australia
| | - Robert I McLachlan
- Monash IVF Group, 89 Bridge Road, Richmond, VIC 3121, Australia.,Department of Obstetrics and Gynecology, Monash Medical Centre, Monash University, 246 Clayton Road, Clayton, VIC 3168, Australia.,Hudson Institute of Medical Research, Monash Medical Centre, Monash University, 246 Clayton Road, Clayton, VIC 3168, Australia
| | - Luk Rombauts
- Monash IVF Group, 89 Bridge Road, Richmond, VIC 3121, Australia.,Department of Obstetrics and Gynecology, Monash Medical Centre, Monash University, 246 Clayton Road, Clayton, VIC 3168, Australia
| | - Darren J Katz
- Men's Health Melbourne, 233 Collins Street, Melbourne, VIC 3000, Australia.,Department of Surgery, Western Health, Melbourne, VIC 3000, Australia
| | - Anusch Yazdani
- Queensland Fertility Group, 55 Little Edward Street, Spring Hill, QLD 4000, Australia
| | - Kristofor Bogoevski
- Histology Services, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia
| | - Crystal Chang
- Histology Services, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia
| | - Michelle L Giles
- Ritchie Centre, Department of Obstetrics and Gynecology, Monash University, Melbourne, VIC 3000, Australia
| | - Alison J Carey
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, 300 Herston Rd, Herston, QLD 4006, Australia
| | - Charles W Armitage
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, 300 Herston Rd, Herston, QLD 4006, Australia
| | - Logan K Trim
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, 300 Herston Rd, Herston, QLD 4006, Australia
| | - Eileen A McLaughlin
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.,School of Science Faculty of Science and Technology, University of Canberra, Kirinari Street, Bruce, ACT 2617, Australia.,School of Biological Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Kenneth W Beagley
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, 300 Herston Rd, Herston, QLD 4006, Australia
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Okereafor K, Ekong I, Okon Markson I, Enwere K. Fingerprint Biometric System Hygiene and the Risk of COVID-19 Transmission. JMIR BIOMEDICAL ENGINEERING 2020. [DOI: 10.2196/19623] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Biometric systems use scanners to verify the identity of human beings by measuring the patterns of their behavioral or physiological characteristics. Some biometric systems are contactless and do not require direct touch to perform these measurements; others, such as fingerprint verification systems, require the user to make direct physical contact with the scanner for a specified duration for the biometric pattern of the user to be properly read and measured. This may increase the possibility of contamination with harmful microbial pathogens or of cross-contamination of food and water by subsequent users. Physical contact also increases the likelihood of inoculation of harmful microbial pathogens into the respiratory tract, thereby triggering infectious diseases. In this viewpoint, we establish the likelihood of infectious disease transmission through touch-based fingerprint biometric devices and discuss control measures to curb the spread of infectious diseases, including COVID-19.
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9
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Oghbaei H, Rastgar Rezaei Y, Nikanfar S, Zarezadeh R, Sadegi M, Latifi Z, Nouri M, Fattahi A, Ahmadi Y, Bleisinger N. Effects of bacteria on male fertility: Spermatogenesis and sperm function. Life Sci 2020; 256:117891. [PMID: 32504760 DOI: 10.1016/j.lfs.2020.117891] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/24/2020] [Accepted: 05/30/2020] [Indexed: 11/24/2022]
Abstract
Bacterial infection can negatively affect different parts of the male genital tract and subsequently cause impaired spermatogenesis and male fertility. However, most of the previous studies have focused on the infected organs of the male genital tract and there are not many studies that investigated the direct effect of bacteria on sperm and their mechanism of action. Interestingly, bacteria can induce different damages on sperm cells such as DNA fragmentation, cell membrane peroxidation, and acrosome impairment. Such negative effects can be mediated by bacteria-secreted toxins and metabolites or by direct attachment of bacteria on the sperm cells and subsequent activation of signaling pathways related to oxidative stress, apoptosis, and inflammation. These bacteria-induced changes can impair semen parameters and subsequently cause infertility. Given the significant destructive effect of some bacteria on sperm function and male fertility, in this study, we reviewed the impact of male urogenital bacteria on spermatogenesis and sperm functions as well as the underlying mechanisms by which the bacteria can damage sperm.
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Affiliation(s)
- Hajar Oghbaei
- Department of Physiology, Tabriz University of Medical Sciences, Tabriz, Iran; Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yeganeh Rastgar Rezaei
- Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saba Nikanfar
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Zarezadeh
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammadreza Sadegi
- Department of Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Latifi
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Nouri
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Fattahi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany.
| | - Yadollah Ahmadi
- Department of Urology, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Nathalie Bleisinger
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
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Ogbonmwan D, Hussey J, Gudipati M. Time to re-evaluate the guidance on sexual infections in fertility services. HUM FERTIL 2020; 24:230-235. [PMID: 31960732 DOI: 10.1080/14647273.2020.1714086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Current guidance in the UK for fertility services on the screening for sexually transmitted infections (STI) is solely directed towards Chlamydia trachomatis. Evidence used to formulate the guidance is based on research undertaken before more sensitive diagnostic methods were available and before testing of some organisms was even possible. This commentary outlines current STI trends, evidence available for STI effect on fertility and new diagnostic methods of screening. It aims to demonstrate that UK guidance should be updated and directed towards areas where further research is required.
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Affiliation(s)
- Daisy Ogbonmwan
- Sunderland Sexual Health, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Jane Hussey
- Sunderland Sexual Health, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Madhavi Gudipati
- Department of Obstetrics and Gynaecology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
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11
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Brunner RJ, Demeter JH, Sindhwani P. Review of Guidelines for the Evaluation and Treatment of Leukocytospermia in Male Infertility. World J Mens Health 2018; 37:128-137. [PMID: 30644236 PMCID: PMC6479086 DOI: 10.5534/wjmh.180078] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 11/20/2018] [Accepted: 12/05/2018] [Indexed: 11/15/2022] Open
Abstract
Leukocytospermia is an ill-defined and poorly understood condition affecting up to 30% of male factor infertility. Current guidelines on leukocytospermia vary significantly, although it has been linked to increased rates of infertility, uncertainty about its clinical significance, diagnosis, and treatment remains. The guidelines are conflicting with sparse data scattered across different specialties and continents. This study aims to compare and contrast available international guidelines and recommendations. In addition to these guidelines, we sought to consolidate the findings of trials over the last several decades. English language articles on human observational studies, retrospective, prospective, clinical trials and randomized control trials were searched for using the following terms: "leukocytospermia, pyospermia, and male infertility." Articles about treatment and management of leukocytospermia that were published between January 2010 and April 2018 were included, as well as four articles referenced in best practice and guideline statements from urological and andrological associations. Disagreements on this topic are highlighted as some guidelines describe no correlation between leukocytospermia and infertility while others show that treatment leads to improvement of sperm quality by many measures including improved pregnancy rate. Various treatments have been suggested including antibiotics, anti-inflammatory medications, and frequent ejaculation. There is a need for definitive characterization of Leukocytospermia as an infectious or inflammatory marker and a re-evaluation of the leukocyte concentration threshold. Additional studies investigating rates of conception as a measure of outcome are needed, to provide greater level of evidence and generalizability of leukocytopsermia management.
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Affiliation(s)
- Robert J Brunner
- College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Jonathan H Demeter
- Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA.
| | - Puneet Sindhwani
- Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
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12
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Motrich RD, Salazar FC, Breser ML, Mackern-Oberti JP, Godoy GJ, Olivera C, Paira DA, Rivero VE. Implications of prostate inflammation on male fertility. Andrologia 2018; 50:e13093. [DOI: 10.1111/and.13093] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 05/30/2018] [Accepted: 06/13/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Ruben D. Motrich
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Centro de Investigaciones en Bioquímica Clínica e Inmunología, CIBICI-CONICET; Universidad Nacional de Córdoba; Córdoba Argentina
| | - Florencia C. Salazar
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Centro de Investigaciones en Bioquímica Clínica e Inmunología, CIBICI-CONICET; Universidad Nacional de Córdoba; Córdoba Argentina
| | - Maria L. Breser
- Instituto A.P. de Ciencias Básicas y Aplicadas; Universidad Nacional de Villa María, Ciudad Universitaria; Villa María, Cordoba Argentina
| | - Juan P. Mackern-Oberti
- Instituto de Medicina y Biología Experimental de Cuyo, IMBECU-CONICET; Mendoza Argentina
- Facultad de Ciencias Médicas, Instituto de Fisiología; Universidad Nacional de Cuyo; Mendoza Argentina
| | - Gloria J. Godoy
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Centro de Investigaciones en Bioquímica Clínica e Inmunología, CIBICI-CONICET; Universidad Nacional de Córdoba; Córdoba Argentina
| | - Carolina Olivera
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Centro de Investigaciones en Bioquímica Clínica e Inmunología, CIBICI-CONICET; Universidad Nacional de Córdoba; Córdoba Argentina
| | - Daniela A. Paira
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Centro de Investigaciones en Bioquímica Clínica e Inmunología, CIBICI-CONICET; Universidad Nacional de Córdoba; Córdoba Argentina
| | - Virginia E. Rivero
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Centro de Investigaciones en Bioquímica Clínica e Inmunología, CIBICI-CONICET; Universidad Nacional de Córdoba; Córdoba Argentina
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13
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Damke E, Kurscheidt FA, Irie MM, Gimenes F, Consolaro MEL. Male Partners of Infertile Couples With Seminal Positivity for Markers of Bacterial Vaginosis Have Impaired Fertility. Am J Mens Health 2018; 12:2104-2115. [PMID: 30132409 PMCID: PMC6199420 DOI: 10.1177/1557988318794522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/12/2018] [Accepted: 07/22/2018] [Indexed: 11/16/2022] Open
Abstract
To access the possibility that key markers of bacterial vaginosis (KM-BV) could affect seminal parameters and thus fertility a prospective cohort study was designed (a) to develop rapid and sensitive multiplex polymerase chain reaction (M-PCR) assays to screen 13 key markers of bacterial vaginosis (KM-BV) in semen specimens, (b) to determine the prevalence of KM-BV in semen from randomized male partners of couples seeking fertility evaluation. A total of 229 semen samples were included in the study from males who visited the Sperm Analysis Section of Brazil between October 2015 and March 2016. Eligible men were 18 years or older and had a semen analysis due fertility evaluation (after failing to conceive with their partner after 1 year of unprotected intercourse). Basic seminal parameters were analyzed, and KM-BV was detected by M-PCR assays. M-PCR assays clearly distinguished 13 KM-BV in 146 semen samples (63.8%), mainly Gardnerella vaginalis (50.7%). Some important associations occurred between the presence of KM-BV in semen and changes in seminal parameters. KM-BV is commonly present in the semen of males seeking fertility evaluation and could potentially play significant roles in male subfertility and/or infertility.
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Affiliation(s)
- Edilson Damke
- State University of Maringá, Maringá, Paraná, Brazil
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Kenny LC, Kell DB. Immunological Tolerance, Pregnancy, and Preeclampsia: The Roles of Semen Microbes and the Father. Front Med (Lausanne) 2018; 4:239. [PMID: 29354635 PMCID: PMC5758600 DOI: 10.3389/fmed.2017.00239] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/12/2017] [Indexed: 12/18/2022] Open
Abstract
Although it is widely considered, in many cases, to involve two separable stages (poor placentation followed by oxidative stress/inflammation), the precise originating causes of preeclampsia (PE) remain elusive. We have previously brought together some of the considerable evidence that a (dormant) microbial component is commonly a significant part of its etiology. However, apart from recognizing, consistent with this view, that the many inflammatory markers of PE are also increased in infection, we had little to say about immunity, whether innate or adaptive. In addition, we focused on the gut, oral and female urinary tract microbiomes as the main sources of the infection. We here marshall further evidence for an infectious component in PE, focusing on the immunological tolerance characteristic of pregnancy, and the well-established fact that increased exposure to the father's semen assists this immunological tolerance. As well as these benefits, however, semen is not sterile, microbial tolerance mechanisms may exist, and we also review the evidence that semen may be responsible for inoculating the developing conceptus (and maybe the placenta) with microbes, not all of which are benign. It is suggested that when they are not, this may be a significant cause of PE. A variety of epidemiological and other evidence is entirely consistent with this, not least correlations between semen infection, infertility and PE. Our view also leads to a series of other, testable predictions. Overall, we argue for a significant paternal role in the development of PE through microbial infection of the mother via insemination.
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Affiliation(s)
- Louise C. Kenny
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Douglas B. Kell
- School of Chemistry, The University of Manchester, Manchester, United Kingdom
- The Manchester Institute of Biotechnology, The University of Manchester, Manchester, United Kingdom
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Ahmadi MH, Mirsalehian A, Sadighi Gilani MA, Bahador A, Afraz K. Association of asymptomatic Chlamydia trachomatis infection with male infertility and the effect of antibiotic therapy in improvement of semen quality in infected infertile men. Andrologia 2018; 50:e12944. [PMID: 29292525 DOI: 10.1111/and.12944] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2017] [Indexed: 11/27/2022] Open
Abstract
The role of asymptomatic infections caused by Chlamydia trachomatis in male infertility and the efficacy of antibiotics in the treatment of this condition are not yet definitely determined. A total of 165 infertile males having abnormal semen parameters (study group) as well as 165 healthy fertile men (control group) were included. Semen samples were taken from all participants and after analysing for semen parameters, undergone real-time PCR, and reactive oxygen species (ROS) as well as total antioxidant capacity (TAC) assays. Infected individuals of study group were treated with antibiotic. One month after the treatment completion, second semen samples were taken and undergone all the tests mentioned. The frequency of C. trachomatis was significantly higher in the infertile men compared with the fertile ones (4.2% vs 0.6%). Most of the semen parameters were improved and reached their normal range, the level of TAC elevated and ROS level as well as ROS/TAC ratio reduced after antibiotic treatment. Moreover, wives of three infected infertile men (42.9%) became pregnant 4 months after the treatment completion. Our data suggest that asymptomatic infection caused by C. trachomatis is correlated with male infertility and antibiotic therapy can improve the semen quality and fairly treat the male infertility.
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Affiliation(s)
- M H Ahmadi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - A Mirsalehian
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - M A Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - A Bahador
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - K Afraz
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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16
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Salarkia E, Sepehri G, Torabzadeh P, Abshenas J, Saberi A. Effects of administration of co-trimoxazole and folic acid on sperm quality and histological changes of testes in male rats. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.10.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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17
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Improvement of semen parameters after antibiotic therapy in asymptomatic infertile men infected with Mycoplasma genitalium. Infection 2017; 46:31-38. [PMID: 29124647 DOI: 10.1007/s15010-017-1075-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To elucidate the association between asymptomatic infections caused by Mycoplasma genitalium and male infertility, and evaluate the role of antibiotic therapy in treatment of this failure. METHODS A total of 165 infertile males having abnormal semen parameters (study group) and 165 healthy fertile men (control group) were included. Semen samples were taken from all participants and after analyzing for semen parameters, undergone real-time PCR, microbial culture, and reactive oxygen species (ROS), as well as total antioxidant capacity (TAC) assays. Infected individuals of study group were treated with antibiotic. One month after the treatment completion, second semen samples were taken and subjected to all the tests mentioned. The data were analyzed using SPSS statistical software, version 22.0. RESULTS The frequency of M. genitalium was significantly higher in the infertile men compared with the fertile ones (9.7% vs. 1.2%; p = 0.001). Mean cycle threshold (C t) value was lower in infected infertile than infected fertile men (p < 0.001). All semen parameters, except volume, pH, and viscosity, were improved (p < 0.05), most of which reached their normal range; leukocytes in seminal fluid decreased (p = 0.02), the level of TAC was elevated (p = 0.002), and ROS level as well as ROS/TAC ratio reduced after antibiotic treatment (p = 0.03). Wives of seven infected infertile men (43.8%) became pregnant 4 months after the treatment completion. CONCLUSIONS Asymptomatic infection caused by M. genitalium is correlated with male infertility and antibiotic therapy can improve the semen quality and be used to treat male infertility.
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Pajovic B, Pajovic L, Vukovic M. Effectiveness of antibiotic treatment in infertile patients with sterile leukocytospermia induced by tobacco use. Syst Biol Reprod Med 2017; 63:391-396. [PMID: 28886262 DOI: 10.1080/19396368.2017.1373158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Our study investigated whether antibiotic therapy in infertile tobacco users with sterile leukocytospermia and a history of former sexual transmitted disease (STD) has an advantage over cessation of smoking alone. For this study, 80 male infertile smokers were divided into two subgroups. The first group numbered 40 patients treated with a two week course of doxycycline, 100 mg, twice daily, while the second group simply ceased smoking. A control group of 20 patients with chronic abacterial prostatitis (CPPS III a) were treated with the same antibiotic for two weeks. Patients from the first group exhibited significantly higher values in semen volume, total motility, and progressive motility of spermatozoa, when compared with the second group, two weeks post treatment. The latter two measures persisted during the 12 week follow up period. In both groups of patients, the correlation coefficient between the number of leukocytes and progressive motility was determined as statistically significant. However, in the control group the correlation was not statistically significant; however progressive motility, total motility, and vitality were significantly improved after a two week course of antibiotics. Our study implies that antibiotic treatment is perhaps effective in treating sterile leukocytospermia in smokers with a former STD and is a more effective treatment option in improving sperm parameters over smoking cessation alone. ABBREVIATIONS STD: sexual transmitted disease; CPPS IIIa: chronic abacterial prostatitis; PSA: prostatic specific antigen; EPS: expressed prostatic secretion; WBC: white blood count; LUTS: lower urinary tract symptoms; PPMT: pre-massage and post-massage urine test; VAS: visual analogue scale.
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Affiliation(s)
- Bogdan Pajovic
- a Faculty of Medicine , University of Montenegro , Podgorica , Montenegro
| | - Ljiljana Pajovic
- b School of Medicine , University of Montenegro , Podgorica , Montenegro
| | - Marko Vukovic
- c Urology Clinic , Clinical Centre of Montenegro , Podgorica , Montenegro
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Morales Berrocal M, Echavarría-Sánchez M, Villeda Gabriel G. Microorganimos patógenos productores de alteraciones seminales relacionadas con infertilidad. PERINATOLOGÍA Y REPRODUCCIÓN HUMANA 2017. [DOI: 10.1016/j.rprh.2018.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Antibiotic treatment of asymptomatic Ureaplasma infection improves semen parameters in infertile men. J Appl Biomed 2017. [DOI: 10.1016/j.jab.2016.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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21
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Chlamydia trachomatis neither exerts deleterious effects on spermatozoa nor impairs male fertility. Sci Rep 2017; 7:1126. [PMID: 28442719 PMCID: PMC5430866 DOI: 10.1038/s41598-017-01262-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 03/27/2017] [Indexed: 12/26/2022] Open
Abstract
Chlamydia trachomatis is the most prevalent sexually transmitted bacterial infection. However, whether Chlamydia trachomatis has a negative impact on sperm quality and male fertility is still controversial. Herein, we report the effects on sperm quality of the in vitro exposure of spermatozoa to Chlamydia trachomatis, and also the effects of male genital infection on male fertility using an animal model. Human and mouse sperm were obtained from healthy donors and cauda epididimys from C57BL/6 mice, respectively. Highly motile human or mouse spermatozoa were in vitro exposed to C. trachomatis (serovar E or LGV) or C. muridarum, respectively. Then, sperm quality parameters were analyzed. Moreover, male fertility of Chlamydia muridarum infected male C57BL/6 mice was assessed. Human or murine sperm in vitro exposed to increasing bacterial concentrations or soluble factors from C. trachomatis or C. muridarum, respectively, did not show differences in sperm motility and viability, apoptosis, mitochondrial membrane potential, DNA fragmentation, ROS production and lipid peroxidation levels, when compared with control sperm (p > 0.05). Moreover, no differences in fertility parameters (potency, fecundity, fertility index, pre- and post-implantation loss) were observed between control and infected males. In conclusion, our results indicate that Chlamydia spp. neither directly exerts deleterious effects on spermatozoa nor impairs male fertility.
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22
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Ahmadi MH, Mirsalehian A, Sadighi Gilani MA, Bahador A, Talebi M. Asymptomatic Infection With Mycoplasma hominis Negatively Affects Semen Parameters and Leads to Male Infertility as Confirmed by Improved Semen Parameters After Antibiotic Treatment. Urology 2017; 100:97-102. [DOI: 10.1016/j.urology.2016.11.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 10/19/2016] [Accepted: 11/11/2016] [Indexed: 12/01/2022]
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23
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Solomon M, Henkel R. Semen culture and the assessment of genitourinary tract infections. Indian J Urol 2017; 33:188-193. [PMID: 28717267 PMCID: PMC5508428 DOI: 10.4103/iju.iju_407_16] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The male factor contributes approximately 50% to infertility-related cases in couples with an estimated 12%–35% of these cases attributable to male genital tract infections. Depending on the nature of the infection, testicular sperm production, sperm transport, and sperm function can be compromised. Yet, infections are potentially treatable causes of infertility. Male genital tract infections are increasingly difficult to detect. Moreover, they often remain asymptomatic (“silent”) with the result that they are then passed on to the relevant sexual partner leading to fertilization and pregnancy failure as well as illness of the offspring. With the worldwide increasing problem of antibiotic resistance of pathogens, proper diagnosis and therapy of the patient is important. This testing, however, should include not only aerobic microbes but also anaerobic as these can be found in almost all ejaculates with about 71% being potentially pathogenic. Therefore, in cases of any indication of a male genital tract infection, a semen culture should be carried out, particularly in patients with questionable semen quality. Globally, an estimate of 340 million new infections with sexually transmitted pathogens is recorded annually. Among these, the most prevalent pathogens including Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae, and Mycoplasma hominis. Escherichia coli are considered the most common nonsexually transmitted urogenital tract microbes. These pathogens cause epididymitis, epididymo-orchitis, or prostatitis and contribute to increased seminal leukocyte concentrations.
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Affiliation(s)
- Michael Solomon
- Department of Medical Biosciences, University of the Western Cape, Bellville, South Africa
| | - Ralf Henkel
- Department of Medical Biosciences, University of the Western Cape, Bellville, South Africa
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24
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Xie QZ, Xu WM, Qi QR, Luo ZL, Dong L. Patients with cervical Ureaplasma Urealyticum and Chlamydia Trachomatis infection undergoing IVF/ICSI-ET: The need for new paradigm. ACTA ACUST UNITED AC 2016; 36:716-722. [PMID: 27752891 DOI: 10.1007/s11596-016-1650-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/07/2016] [Indexed: 11/28/2022]
Abstract
Genital tract infections with ureaplasma urealyticum (UU) and chlamydia trachomatis (CT) are the most frequent sexually-transmitted disease worldwide. UU and CT infections are considered to be the leading cause for infertility and adverse pregnancy outcomes. However, little is known about the specific effect of cervical UU and CT infections on the etiology of female infertility, as well as the pregnancy outcomes of the patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). In order to find the association between cervical UU and/or CT infection and pregnancy outcomes, we conducted a retrospective case-control study on the patients undergoing IVF/ICSI-ET with cervical UU and/or CT infection. A total of 2208 patients who received IVF/ICSI-ET were enrolled in this study. Data on the general conditions, pregnancy history and clinical pregnant outcomes were analyzed in terms of the cervical UU and CT detection. Our results revealed that cervical UU and CT infections were the risk factors for ectopic pregnancy and tubal factor-induced infertility. Moreover, the pregnancy rate, abortion rate, ectopic pregnancy rate and premature birth rate in patients with UU and/or CT infections showed no significant difference when compared with the control group. We recommend that cervical UU and CT detection should be an optional item for infertility patients and clinical UU detection should differentiate the subtypes of cervical UU. Positive cervical UU and CT infections should not be taken as strict contraindications for IVF/ICSI-ET.
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Affiliation(s)
- Qing-Zhen Xie
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Wang-Ming Xu
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
| | - Qian-Rong Qi
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Zeng-Li Luo
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Lan Dong
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
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Pajovic B, Radojevic N, Dimitrovski A, Vukovic M. Comparison of the efficiency of combined extracorporeal shock-wave therapy and triple therapy versus triple therapy itself in Category III B chronic pelvic pain syndrome (CPPS). Aging Male 2016; 19:202-207. [PMID: 27380504 DOI: 10.1080/13685538.2016.1197899] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The aim of this study is to determine the effect of combining extracorporeal shock-wave therapy (ESWT) and triple therapy versus triple therapy alone, when treating Category III B chronic prostatitis (CPPS). Study included 60 patients, classified as having CPPS, divided into two groups: the first group numbered 30 patients, who were treated with a combination of an α-blocker, an anti-inflammatory agent and a muscle relaxant; the second group consisted of 30 patients who received a combination of ESWT and the fore-mentioned triple therapy. Patients were treated for 12 weeks. The primary criterion of a response to therapy was scoring 2 or less on the NIH-CPSI quality of life item, while the secondary criterion of a response to therapy was a greater than a 50% reduction in NIH-CPSI pain score. Patients who received triple therapy did not show a significant change neither in post void residual urine (PVR) nor in maximum flow rate (QMAX), while the second group of patients exhibited significant improvement in both PVR and QMAX values. Both groups of patients showed statistically significant improvement in all items of the NIH-CPSI score after the treatment, with significantly better results in the second group.
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Affiliation(s)
- B Pajovic
- a Urology and Nephrology Clinic, Clinical Centre of Montenegro , Podgorica , Montenegro
| | - N Radojevic
- b Center of Pathology and Forensic Medicine, Clinical Centre of Montenegro, Faculty of Medicine, University of Montenegro , Podgorica , Montenegro , and
| | - A Dimitrovski
- c Urology Clinic, Clinical Centre of Kragujevac , Kragujevac , Serbia
| | - M Vukovic
- a Urology and Nephrology Clinic, Clinical Centre of Montenegro , Podgorica , Montenegro
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26
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Weberschock T, Valipour A, Ochsendorf F. [Semen analysis in involuntary childlessness. What information does it provide?]. Hautarzt 2015; 66:924-32. [PMID: 26452353 DOI: 10.1007/s00105-015-3707-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Involuntary childlessness is a common problem. In about 50% of cases, inadequate semen quality plays a relevant role. A semen analysis provides information regarding exocrine function of the male reproductive organs of the testes, epidydimis, seminal vesicles, prostate gland, and vas deferens. These parameters can only be interpreted in conjunction with medical history and physical examination. Then they can be useful to identify relevant disorders or the causes of these disturbances. The fundamental principles for the interpretation of a semen analysis are easily learned and traditionally belong to the field of dermatology. This article explains the variables which are examined in a routine semen analysis as well as the reference values. Furthermore, common causes for deviations from the normal values are discussed to allow decision-making for further diagnostic workup. The interpretation of these values must always take into account the situation of the couple.
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Affiliation(s)
- T Weberschock
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum, Theodor-Stern-Kai 7, 60590, Frankfurt/M., Deutschland. .,Arbeitsgruppe Evidenzbasierte Medizin, Institut für Allgemeinmedizin, Goethe-Universität, Frankfurt, Deutschland.
| | - A Valipour
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum, Theodor-Stern-Kai 7, 60590, Frankfurt/M., Deutschland
| | - F Ochsendorf
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum, Theodor-Stern-Kai 7, 60590, Frankfurt/M., Deutschland
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27
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Pajovic B, Dimitrovski A, Radojevic N, Vukovic M. Comparison of Sperm Parameters in Patients with Infertility Induced by Genital Infection versus Varicocele. Balkan Med J 2015; 32:255-9. [PMID: 26185712 DOI: 10.5152/balkanmedj.2015.15871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 05/05/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Male infertility is a common and complex problem and, despite much research in this field, the major cause of infertility unfortunately remains unknown. Genital infection and varicocele are important causes of infertility. AIMS To compare the influence of genital infection and varicocele individually on male infertility based on semen analysis. STUDY DESIGN Cross-sectional study. METHODS The study included 120 infertile patients divided into two groups according to the presence of genital infection or varicocele. The first group included 60 examinees with proven genital infection, but without varicocele formation. The second included 60 patients with varicocele, regardless of the varicocele grade, but without genital infection. The fertile parameters were compared and an assessment was performed on the impact on quality of spermatogenesis due to infection and varicocele. RESULTS There is a statistically significant difference regarding abnormal forms of spermatozoids (45.94±9.79 vs. 25.27±6.54) and progressive motility (8.15±1.24 vs. 24.95±7.2), between two groups of patients. However, acidity of ejaculates, minimum sperm concentration, total spermatozoid motility and ejaculate volume showed no statistically significant difference. CONCLUSION The study showed a stronger negative influence of genital infection on fertile parameters over varicocele. The significance of our study is the lack of contemporary researches comparing varicocele and genital infection influence on male infertility individually.
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Affiliation(s)
- Bogdan Pajovic
- Department of Surgery, Montenegro University Faculty of Medicine, Podgorica, Montenegro
| | | | - Nemanja Radojevic
- Department of Forensic Medicine, Montenegro University Faculty of Medicine, Podgorica, Montenegro
| | - Marko Vukovic
- Department of Surgery, Montenegro University Faculty of Medicine, Podgorica, Montenegro
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28
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Transient exposure to Chlamydia trachomatis can induce alteration of sperm function which cannot be stopped by sperm washing. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2015. [DOI: 10.1016/j.mefs.2014.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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29
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Chlamydia trachomatis and Genital Mycoplasmas: Pathogens with an Impact on Human Reproductive Health. J Pathog 2014; 2014:183167. [PMID: 25614838 PMCID: PMC4295611 DOI: 10.1155/2014/183167] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 12/09/2014] [Accepted: 12/11/2014] [Indexed: 11/30/2022] Open
Abstract
The most prevalent, curable sexually important diseases are those caused by Chlamydia trachomatis (C. trachomatis) and genital mycoplasmas. An important characteristic of these infections is their ability to cause long-term sequels in upper genital tract, thus potentially affecting the reproductive health in both sexes. Pelvic inflammatory disease (PID), tubal factor infertility (TFI), and ectopic pregnancy (EP) are well documented complications of C. trachomatis infection in women. The role of genital mycoplasmas in development of PID, TFI, and EP requires further evaluation, but growing evidence supports a significant role for these in the pathogenesis of chorioamnionitis, premature membrane rupture, and preterm labor in pregnant woman. Both C. trachomatis and genital mycoplasmas can affect the quality of sperm and possibly influence the fertility of men. For the purpose of this paper, basic, epidemiologic, clinical, therapeutic, and public health issue of these infections were reviewed and discussed, focusing on their impact on human reproductive health.
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30
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Sobinoff AP, Dando SJ, Redgrove KA, Sutherland JM, Stanger SJ, Armitage CW, Timms P, McLaughlin EA, Beagley KW. Chlamydia muridarum infection-induced destruction of male germ cells and sertoli cells is partially prevented by Chlamydia major outer membrane protein-specific immune CD4 cells. Biol Reprod 2014; 92:27. [PMID: 25472923 DOI: 10.1095/biolreprod.114.124180] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Chlamydia trachomatis infections are increasingly prevalent worldwide. Male chlamydial infections are associated with urethritis, epididymitis, and orchitis; however, the role of Chlamydia in prostatitis and male factor infertility remains controversial. Using a model of Chlamydia muridarum infection in male C57BL/6 mice, we investigated the effects of chlamydial infection on spermatogenesis and determined the potential of immune T cells to prevent infection-induced outcomes. Antigen-specific CD4 T cells significantly reduced the infectious burden in the penile urethra, epididymis, and vas deferens. Infection disrupted seminiferous tubules, causing loss of germ cells at 4 and 8 wk after infection, with the most severely affected tubules containing only Sertoli cells. Increased mitotic proliferation, DNA repair, and apoptosis in spermatogonial cells and damaged germ cells were evident in atrophic tubules. Activated caspase 3 (casp3) staining revealed increased (6-fold) numbers of Sertoli cells with abnormal morphology that were casp3 positive in tubules of infected mice, indicating increased levels of apoptosis. Sperm count and motility were both decreased in infected mice, and there was a significant decrease in morphologically normal spermatozoa. Assessment of the spermatogonial stem cell population revealed a decrease in promyelocytic leukemia zinc finger (PLZF)-positive cells in the seminiferous tubules. Interestingly, adoptive transfer of antigen-specific CD4 cells, particularly T-helper 2-like cells, prior to infection prevented these effects in spermatogenesis and Sertoli cells. These data suggest that chlamydial infection adversely affects spermatogenesis and male fertility, and that vaccination can potentially prevent the spread of infection and these adverse outcomes.
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Affiliation(s)
- Alexander P Sobinoff
- Priority Research Centres in Chemical Biology and Reproductive Science, School of Environmental & Life Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Samantha J Dando
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kate A Redgrove
- Priority Research Centres in Chemical Biology and Reproductive Science, School of Environmental & Life Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Jessie M Sutherland
- Priority Research Centres in Chemical Biology and Reproductive Science, School of Environmental & Life Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Simone J Stanger
- Priority Research Centres in Chemical Biology and Reproductive Science, School of Environmental & Life Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Charles W Armitage
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Peter Timms
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Eileen A McLaughlin
- Priority Research Centres in Chemical Biology and Reproductive Science, School of Environmental & Life Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Kenneth W Beagley
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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31
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Redgrove KA, McLaughlin EA. The Role of the Immune Response in Chlamydia trachomatis Infection of the Male Genital Tract: A Double-Edged Sword. Front Immunol 2014; 5:534. [PMID: 25386180 PMCID: PMC4209867 DOI: 10.3389/fimmu.2014.00534] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 10/09/2014] [Indexed: 01/16/2023] Open
Abstract
Chlamydia trachomatis (CT) is the most prevalent bacterial sexually transmitted infection in the world, with more than 100 million cases reported annually. While there have been extensive studies into the adverse effects that CT infection has on the female genital tract, and on the subsequent ability of these women to conceive, studies into the consequences on male fertility have been limited and controversial. This is in part due to the asymptomatic nature of the infection, where it is estimated that 50% of men with Chlamydia fail to show any symptoms. It is accepted, however, that acute and/or persistent CT infection is the causative agent for conditions such as urethritis, epididymitis, epididymo-orchitis, and potentially prostatitis. As with most infections, the immune system plays a fundamental role in the body’s attempts to eradicate the infection. The first and most important immune response to Chlamydia infection is a local one, whereby immune cells such as leukocytes are recruited to the site of infections, and subsequently secrete pro-inflammatory cytokines and chemokines such as interferon gamma. Immune cells also work to initiate and potentiate chronic inflammation through the production of reactive oxygen species (ROS), and the release of molecules with degradative properties including defensins, elastase, collagenase, cathespins, and lysozyme. This long-term inflammation can lead to cell proliferation (a possible precursor to cancer), tissue remodeling, and scarring, as well as being linked to the onset of autoimmune responses in genetically disposed individuals. This review will focus on the ability of the immune system to recognize and clear acute and persistent chlamydial infections in the male genital tract, and on the paradoxical damage that chronic inflammation resulting from the infection can cause on the reproductive health of the individual.
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Affiliation(s)
- Kate A Redgrove
- Priority Research Centre in Reproductive Biology and Chemical Biology, University of Newcastle , Callaghan, NSW , Australia ; School of Environmental and Life Science, University of Newcastle , Callaghan, NSW , Australia
| | - Eileen A McLaughlin
- Priority Research Centre in Reproductive Biology and Chemical Biology, University of Newcastle , Callaghan, NSW , Australia ; School of Environmental and Life Science, University of Newcastle , Callaghan, NSW , Australia
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32
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Male infertility: a public health issue caused by sexually transmitted pathogens. Nat Rev Urol 2014; 11:672-87. [PMID: 25330794 DOI: 10.1038/nrurol.2014.285] [Citation(s) in RCA: 134] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Sexually transmitted diseases (STDs) are caused by several pathogens, including bacteria, viruses and protozoa, and can induce male infertility through multiple pathophysiological mechanisms. Additionally, horizontal transmission of STD pathogens to sexual partners or vertical transmission to fetuses and neonates is possible. Chlamydia trachomatis, Ureaplasma spp., human papillomavirus, hepatitis B and hepatitis C viruses, HIV-1 and human cytomegalovirus have all been detected in semen from symptomatic and asymptomatic men with testicular, accessory gland and urethral infections. These pathogens are associated with poor sperm quality and decreased sperm concentration and motility. However, the effects of these STD agents on semen quality are unclear, as are the effects of herpes simplex virus type 1 and type 2, Neisseria gonorrhoeae, Mycoplasma spp., Treponema pallidum and Trichomonas vaginalis, because few studies have evaluated the influence of these pathogens on male infertility. Chronic or inadequately treated infections seem to be more relevant to infertility than acute infections are, although in many cases the exact aetiological agents remain unknown.
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Filipiak E, Marchlewska K, Oszukowska E, Walczak-Jedrzejowska R, Swierczynska-Cieplucha A, Kula K, Slowikowska-Hilczer J. Presence of aerobic micro-organisms and their influence on basic semen parameters in infertile men. Andrologia 2014; 47:826-31. [PMID: 25209133 DOI: 10.1111/and.12338] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2014] [Indexed: 11/28/2022] Open
Abstract
Urogenital tract infections in males are one of the significant etiological factors in infertility. In this prospective study, 72 patients with abnormal semen parameters or any other symptoms of urogenital tract infection were examined. Semen analysis according to the WHO 2010 manual was performed together with microbial assessment: aerobic bacteria culture, Chlamydia antigen test, Candida culture, Ureaplasma and Mycoplasma-specific culture. In total, 69.4% of semen samples were positive for at least one micro-organism. Ureaplasma sp. was the most common micro-organism found in 33% of semen samples of infertile patients with suspected male genital tract infection. The 2nd most common micro-organisms were Enterococcus faecalis (12.5%) and Escherichia coli (12.5%), followed by Staphylococcus aureus (7%), Chlamydia trachomatis (7%) and Candida sp. (5.6%). Generally, bacteria were sensitive to at least one of the antibiotics tested. No statistically significant relationship was observed between the presence of aerobic micro-organisms in semen and basic semen parameters: volume, pH, concentration, total count, motility, vitality and morphology.
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Affiliation(s)
- E Filipiak
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland
| | - K Marchlewska
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland
| | - E Oszukowska
- II Clinic of Urology, Medical University of Lodz, Lodz, Poland
| | - R Walczak-Jedrzejowska
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland
| | - A Swierczynska-Cieplucha
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland
| | - K Kula
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland
| | - J Slowikowska-Hilczer
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland
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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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