Infection in Infertility

Henkel, Ralf

doi:10.1007/978-3-030-32300-4_32

Cited by 6 publications

(5 citation statements)

References 209 publications

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“…The most frequently found pathogens in the male genital tract, including sexually transmitted infections, are Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae, Mycoplasma hominis, Mycoplasma genitalium, Staphylococcus aureus, Streptococci or Enterococcus faecalis [19,37,44]. Escherichia coli, another frequently detected pathogen, causes epididymo-orchitis and prostatitis in 65% to 80% of cases [18].…”

Section: Male Genital Tract Infectionsmentioning

confidence: 99%

“…These, and other pathogens, such as Treponema pallidum, Trypanosoma spp. and Schistosoma spp., or even viruses can cause infections of the whole male genital tract, such as orchitis, epididymitis, prostatitis, vesiculitis, urethritis or balanitis [19], causing infertility; they can even have long-term consequences for male sexual functions [20].…”

Section: Male Genital Tract Infectionsmentioning

confidence: 99%

“…Treatment, however, strictly depends on the type of pathogen, with the first choice of therapy being antibiotics to eradicate the pathogens and normalize ROS and inflammatory parameters. It needs to be stressed that both partners have to be tested and treated, as many of these pathogens are sexually transmitted [19,121]. The type of treatment also depends on the location of the infection.…”

Section: Clinical Management Of Bacteriospermiamentioning

confidence: 99%

“…Genital tract infection and inflammation go together with an infiltration of the male genital tract with bacteria and leukocytes and can cause serious damage to spermatogenesis in the testes and sperm transit through the genital tract, affecting the functionality of the male accessory sex gland [14][15][16]. Depending on the pathogen, the damage includes impairment of the blood-testis barrier [17], inflammation with dysfunction of the accessory sex glands, hormonal imbalances [18][19][20] or sperm agglutination [21] and impaired sperm functions [22]. The action of pathogens can either be direct by direct interference of bacteria with the male germ cells [23][24][25][26] or indirect by triggering an inflammatory response in the genital tract with the stimulation of leukocytes, which release reactive oxygen species (ROS) and cytokines [27][28][29].…”

Section: Introductionmentioning

confidence: 99%

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Leukocytospermia and/or Bacteriospermia: Impact on Male Infertility

Henkel

2024

JCM

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Infertility is a globally underestimated public health concern affecting almost 190 million people, i.e., about 17.5% of people during their lifetime, while the prevalence of male factor infertility is about 7%. Among numerous other causes, the prevalence of male genital tract infections reportedly ranges between 10% and 35%. Leukocytospermia is found in 30% of infertile men and up to 20% in fertile men. Bacterial infections cause an inflammatory response attracting leukocytes, which produce reactive oxygen species (ROS) and release cytokines, both of which can cause damage to sperm, rendering them dysfunctional. Although leukocytospermia and bacteriospermia are both clinical conditions that can negatively affect male fertility, there is still debate about their impact on assisted reproduction outcomes and management. According to World Health Organization (WHO) guidelines, leukocytes should be determined by means of the Endtz test or with monoclonal antibodies against CD15, CD68 or CD22. The cut-off value proposed by the WHO is 1 × 106 peroxidase-positive cells/mL. For bacteria, Gram staining and semen culture are regarded as the “gold standard”, while modern techniques such as PCR and next-generation sequencing (NGS) are allowing clinicians to detect a wider range of pathogens. Whereas the WHO manual does not specify a specific value as a cut-off for bacterial contamination, several studies consider semen samples with more than 103 colony-forming units (cfu)/mL as bacteriospermic. The pathogenic mechanisms leading to sperm dysfunction include direct interaction of bacteria with the male germ cells, bacterial release of spermatotoxic substances, induction of pro-inflammatory cytokines and ROS, all of which lead to oxidative stress. Clinically, bacterial infections, including “silent” infections, are treatable, with antibiotics being the treatment of choice. Yet, non-steroidal antiphlogistics or antioxidants should also be considered to alleviate inflammatory lesions and improve semen quality. In an assisted reproduction set up, sperm separation techniques significantly reduce the bacterial load in the semen. Nonetheless, contamination of the semen sample with skin commensals should be prevented by applying relevant hygiene techniques. In patients where leukocytospermia is detected, the causes (e.g. infection, inflammation, varicocele, smoking, etc.) of the leukocyte infiltration have to be identified and addressed with antibiotics, anti-inflammatories or antioxidants in cases where high oxidative stress levels are detected. However, no specific strategy is available for the management of leukocytospermia. Therefore, the relationship between bacteriospermia and leukocytospermia as well as their specific impact on functional sperm parameters and reproductive outcome variables such as fertilization or clinical pregnancy must be further investigated. The aim of this narrative review is to provide an update on the current knowledge on leukocytospermia and bacteriospermia and their impact on male fertility.

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Section: Male Genital Tract Infectionsmentioning

confidence: 99%

Section: Male Genital Tract Infectionsmentioning

confidence: 99%

Section: Clinical Management Of Bacteriospermiamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Leukocytospermia and/or Bacteriospermia: Impact on Male Infertility

Henkel

2024

JCM

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“…While leukocytospermia may suggest an infectious process such as male accessory gland infection, recent studies indicate that elevated WBC levels can occur without infection or immune response [44]. Moreover, leukocytospermia has been linked to detrimental effects on sperm function attributed to ROS generation [44][45][46]. Increased seminal WBC levels were observed in infertile men compared to healthy controls.…”

Section: Leukocytospermia and Osmentioning

confidence: 99%

Oxidative Stress-Associated Male Infertility: Current Diagnostic and Therapeutic Approaches

Pavuluri,

Bakhtiary,

Panner Selvam

et al. 2024

Medicina

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Infertility is a prevalent global issue affecting approximately 17.5% of adults, with sole male factor contributing to 20–30% of cases. Oxidative stress (OS) is a critical factor in male infertility, disrupting the balance between reactive oxygen species (ROS) and antioxidants. This imbalance detrimentally affects sperm function and viability, ultimately impairing fertility. OS also triggers molecular changes in sperm, including DNA damage, lipid peroxidation, and alterations in protein expression, further compromising sperm functionality and potential fertilization. Diagnostic tools discussed in this review offer insights into OS markers, antioxidant levels, and intracellular ROS concentrations. By accurately assessing these parameters, clinicians can diagnose male infertility more effectively and thus tailor treatment plans to individual patients. Additionally, this review explores various treatment options for males with OS-associated infertility, such as empirical drugs, antioxidants, nanoantioxidants, and lifestyle modifications. By addressing the root causes of male infertility and implementing targeted interventions, clinicians can optimize treatment outcomes and enhance the chances of conception for couples struggling with infertility.

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Oxidative Stress and Toxicity in Reproductive Biology and Medicine: Historical Perspectives and Future Horizons in Male Fertility

Henkel

2022

Advances in Experimental Medicine and Biology

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Infection in Infertility

Cited by 6 publications

References 209 publications

Leukocytospermia and/or Bacteriospermia: Impact on Male Infertility

Leukocytospermia and/or Bacteriospermia: Impact on Male Infertility

Oxidative Stress-Associated Male Infertility: Current Diagnostic and Therapeutic Approaches

Oxidative Stress and Toxicity in Reproductive Biology and Medicine: Historical Perspectives and Future Horizons in Male Fertility

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