Male infertility and genital chlamydial infection: victim or perpetrator?

Abstract

The role of Chlamydia trachomatis in the cause of male infertility is under discussion. This paper attempts to summarize data from the literature, which support the role of C. trachomatis in male infertility or oppose this suggestion. The following observations are based on a survey of the literature: 1) Chlamydia trachomatis is a frequent pathogen in male genital inflammation, the micro-organisms are rarely present in healthy men. 2) Without doubt, C. trachomatis causes inflammations of the male urethra and the epididymis. Prostatitis and glandulitis vesicalis are discussed controversially. 3) Chlamydia trachomatis antigen or DNA is not demonstrable in secretions of the male accessory glands including the semen with sufficient reproducibility. However, it is easily demonstrable in urethral swabs and the urine. 4) Determination of chlamydial antibodies in serum or semen does not conclusively indicate a current infection with C. trachomatis. 5) There are no conclusive studies showing that men infected with C. trachomatis are less fertile than uninfected men. 6) The male genital chlamydial infection is a threat to the female genital organs, because C. trachomatis infection of the female genital organs may be deleterious to female fertility.

Innate immunity in the male genital tract: Chlamydia trachomatis induces keratinocyte-derived chemokine production in prostate, seminal vesicle and epididymis/vas deferens primary cultures

“…Expression, function and synergism of individual TLR molecules would be crucial for understanding local innate immunity against specific pathogens. The reproductive tract, especially the lower genital tract, is continuously challenged by potential pathogens present in the environment (Krause & Bohring, 2003;Krause, 2008). Therefore, robust host defence mechanisms are essential for both health and fertilization.…”

REVIEW ARTICLE: Chlamydia trachomatis, a Hidden Epidemic: Effects on Female Reproduction and Options for Treatment

“…It is thought that Chlamydia can gain access to the URT of women by attachment to sperm. 14,15 It is also possible that movement along the reproductive tract is from general flow of fluids ( Fig. 1), with studies demonstrating that particles approximately the same size of sperm, 16 or radio-labeled sperm, 17 deposited into the vagina of women, could be found in the uterus within 2 min, demonstrating that rapid ascension of bacteria could occur.…”

Genital Chlamydia trachomatis infections

“…e infertilità maschile tanto che alcuni autori concludono che forse il solo aspetto importante di un'infezione nell'uomo è che costituisce un reservoir aumentando le possibilità di infezione nella donna. Molti studi hanno cercato di correlare la presenza di markers sierologici di infezione pregressa con la qualità dello sperma, in realtà non sono state descritte differenze significative tra uomini con pregressa infezione e non (63,83). Altri, pur confermando ciò, mettono in evidenza una stretta associazione tra assenza di concepimento e presenza di IgG anti Chlamydia nell'uomo indipendentemente dalla qualità dello sperma (57).…”