With approximately 90 million cases annually, infection with Chlamydia trachomatis is the most prevalent sexually transmitted bacterial disease in the world. Considering that these infections are often asymptomatic and cause major complications like acute pelvic inflammatory disease, ectopic pregnancy, infertility or infant pneumonia, the estimated costs for diagnosis and treatment in the USA amounts to 2.2 million US dollars for each 500 cases. Therefore, there is a high need for correct, quick and cost-effective diagnosis and treatment of this urogenital tract infection. New innovative therapies provide good results with regard to efficacy and patients' compliance. The success rates of treatments are at least 95%. However, the occurrence of antibiotic resistance should not be ignored and new treatment schemes must be developed. The state-of-the-art of diagnosis and treatment of chlamydial infections as well as the pathophysiology is discussed in this review. In conclusion, infections with C. trachomatis is an important public health problem, especially in third world and developing countries, and more socio-economic studies linking secondary prevention of chlamydial infections, infertility and adverse pregnancy outcome are needed to understand more of its aetiology. In addition, diagnosis and treatment should be improved. Data in men revealed that past infections but not present infections are more related to male infertility. There is still controversial results. In future studies, function of the seminal vesicles and evaluation of the antioxidant capacity should be taken into account when role of C. trachomatis infection on male fertility is assessed.

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Results suggest a protective role of AAb during pregnancy.

The study was designed to determine whether hyperviscosity of the semen sample is related to dysfunction of the male accessory glands. It was carried out on men who consecutively attended an infertility clinic between June 1989 and June 1991, and the men were grouped according to viscosity of semen samples (normal viscosity or higher viscosity). Semen samples from 229 infertility patients were studied. From these, 155 had normal viscosity and 74 showed hyperviscosity. The effect of hyperviscosity of semen samples on seminal quality and the function of the prostate was evaluated by acid phosphatase measurement, and the seminal vesicles by measurement of corrected fructose. Sperm motility (grades II-III), sperm vitality, and corrected fructose were significantly reduced in samples with high viscosity (p < .05). A high prevalence of hyperviscosity in semen samples was associated with only hypofunction of the seminal vesicles. In fact, 36.5% of subjects with hyperviscosity showed reduced levels of corrected fructose. The same association with hyperviscosity was not observed when only hypofunction of the prostate was present, or when hypofunction of both prostate and seminal vesicles was present (P:NS). Further analysis showed that high viscosity is observed mainly when corrected seminal fructose levels were below 1.5 mg/mL x 10(6) spz/mL. It would appear that hyperviscosity affects sperm motility and is associated with hypofunction of the seminal vesicles.

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