Assessment of Chlamydia trachomatis, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, and Mycoplasma genitalium in Semen and First Void Urine Specimens of Asymptomatic Male Partners of Infertile Couples

Abstract

The purpose of this study was threefold: to compare semen and first void urine (FVU) specimens from asymptomatic infertile men for the detection of Chlamydia trachomatis, genital ureaplasma, and genital mycoplasma infections using in-house inhibitor-controlled polymerase chain reaction (PCR)-microtiter plate hybridization assay; to determine the prevalence of those organisms in infertile men in Tunisia; and to study the relationship between these bacteria and male infertility. Paired urine and semen specimens from 104 patients were examined by in-house PCR for the presence of DNA of Chlamydia trachomatis, genital ureaplasmas (Ureaplasma urealyticum and Ureaplasma parvum) and genital mycoplasmas (Mycoplasma hominis and Mycoplasma genitalium). Semen analysis was assessed according to the guidelines of the World Health Organization. Nominal scale variables, the Mann-Whitney test, and the Kruskal-Wallis nonparametric analysis of variance test were used for statistical analysis. There was a very high concordance (.95%) and a very good agreement (k . 0.9) between the detection of Chlamydia trachomatis, genital ureaplasmas, and Mycoplasma hominis in semen and corresponding FVU specimens. Our findings also show a high concordance (81.1%) and a good agreement (k 5 0.79) between the detection of Mycoplasma genitalium in both specimens. C trachomatis, genital mycoplasmas, and genital ureaplasmas were found to be widespread among infertile male patients in Tunisia, as shown by their respective prevalences of 43.3%, 18.3%, and 14.4%. The mean values of seminal volume, sperm concentration, sperm viability, sperm motility, sperm morphology, and leukocyte count were not significantly related either to the detection of C trachomatis DNA or to that of genital ureaplasma or mycoplasma DNA in semen specimens. Using our in-house PCR, both semen and FVU were found to be sensitive diagnostic specimens for the detection of C trachomatis, ureaplasmas, and mycoplasmas. The FVU, a less invasive and self-collected specimen, can serve as a marker for the presence of these organisms in the genital tract and can be used as a reliable way of detecting asymptomatic carriers of infection.

The Role of Chlamydia trachomatis in Male Infertility

“…However, Vigil et al did not found significant differences between C. trachomatis-infected and -noninfected male partners of infertile couples in any of the sperm parameters assessed (sperm concentration, motility and morphology) [57]. Gdoura et al reported that the mean values of seminal volume, sperm concentration, sperm viability, sperm motility, sperm morphology, and leukocyte count were not significantly related to the detection of C. trachomatis DNA in semen specimens of male partners of infertile couples [65]. Finally, another example of the controversial role of C. trachomatis in semen parameters is observed in prostatitis patients.…”

“…However, Bezold et al found no difference in prevalence of C. trachomatis and other pathogens between asymptomatic male infertile patients with and without leukocytospermia [82]. Also, other authors found no relation between infection with C. trachomatis and leukocyte count in semen [65,83,84].…”

“…Moreover, the prevalence of these infections was found to be the same in fertile and infertile groups [132]. Gdoura et al found that the mean values of seminal volume, sperm concentration, sperm viability, sperm motility, sperm morphology, and leukocyte count were not significantly related either to the detection of C. trachomatis D N A o r t o t h a t o f g e n i t a l u r e a p l a s m a or mycoplasma DNA in semen specimens of asymptomatic male partners of infertile couples [65]. Bezold et al detected the presence of DNA of CMV, HPV, human herpesvirus type 6, HSV, HBV, EBV, and C. trachomatis in semen from asymptomatic infertile men.…”

Role of genital tract infections and inflammatory processes in male infertility

“…Ejaculate testing for C. trachomatis is a relatively recent concept and currently there is no approved methodology, the role of seminal testing being unknown. The presence of C. trachomatis in seminal material is believed to indicate an upper genital tract infection (Eggert-Kruse et al, 1997;Gdoura et al, 2008;Kokab., et al, 2010;Gallegos-Avila et al, 2008). The main localization of Chlamydia infection is urethra (Mulcahy et al, 1987) with subsequent evolution in epididym and testis (Trojian et al, 2009).…”

Current Status of the Mollicute (Mycoplasma) Lung Disease: Pathogenesis, Diagnostics, Treatment and Prevention

“…Genital ureaplasmas are natural residents of male urethra contaminating the semen during ejaculation. However, these microorganisms, particularly U. urealyticum, play and etiologic role in both genital infections and male infertility (Gdoura et al, 2008). Recent studies reveal that U. urealyticum strains are isolated more often in men with non-gonococcal urethritis than in healthy men Maeda et al, 2004;Povlsen et al, 2002).…”