Infection in the male reproductive tract. Impact, diagnosis and treatment in relation to male infertility

Abstract

The following are the conclusions that can be derived from a review of the literature regarding the role of infection in the aetiology of male infertility. (i) Temporary inflammatory episodes in the male reproductive tract which are self-limiting are probably common. (ii) Caution should be exercised in the use of leukospermia or bacteriospermia as parameters for glandular infection. (iii) There is a need for alternative techniques for detecting non-symptomatic deep pelvic infections in the male; one technique of great promise is rectal ultrasound. (iv) Rectal ultrasound indicates that a large number of men with poor sperm quality have a non-symptomatic, chronic prostatovesiculitis. (v) Increasing evidence implicates Chlamydia trachomatis as being a major cause of chronic non-bacterial prostatitis. (vi) An important aspect of chlamydial infections in men may be that the male accessory sex glands may function as reservoirs for the organism, increasing the probability of infection in the female. (vii) Ureaplasma urealyticum may also play an important aetiological role in male infertility but its significance is confounded by its acknowledged function as a commensal in the reproductive tract. (viii) One of the manifestations of male reproductive tract infection is the induction of sperm autoantibodies. (ix) There is a need for more systematic controlled studies of the effects of antibiotic treatment on sperm quality with different preparations for extended periods using patient groups in which a glandular infection has been verified, e.g. by rectal ultrasonography.

The Impact of Bacterial Infections on Human Spermatozoa

“…3) Induction of sperm autoantibodies (73). 4) Some microbial pathogens may affect the sperm, resulting in the expression of some surface virulent factors such as lipopolysaccharides (LPS), cytotoxic necrotising factor, α-haemolysins and ß-haemolysins, and from the release of soluble spermatotoxic factors such as sperm immobilisation factor (SIF) (74,75).…”

Testicular innate immune defense against bacteria

“…Bacteria eliciting epididymoorchitis are either sexually transmitted or originate from urinary tract infections (Purvis & Christiansen, 1993;Weidner et al, 1999;Anders & Patole, 2005;Ludwig, 2008). Among sexually active men younger than 35 years with a medical history of urethral discharge, the most prevalent pathogens related to epididymo-orchitis are Chlamydia trachomatis and Neisseria gonorrhoeae (Weidner et al, 1999;Ludwig, 2008;Ochsendorf, 2008).…”

Effect of Seminal Plasma Calcitonin Levels on Sperm Motility

“…Although numerous studies have been performed on sperm motility, many controversies about the mechanism of this function still exist [3,13].…”