Background: The role of UU in the pathogenesis of male infertility is currently not fully understood. Despite the widespread use of antibiotic-resistant UU strains, there is virtually no data on their effect on the morphofunctional characteristics of sperm and the biochemical parameters of the ejaculate.
Aims: Comprehensive evaluation of sperm fertility in men infected with antibiotic-resistant UU strains.
Methods: Semen of men of active reproductive age (n=4752, age from 18 to 46 years, average age 27.84.4 years) was studied. In the semen samples, UU was detected by microbiological method (seeding on selective culture media with subsequent identification and determination of the antibiotic sensitivity of the obtained isolates). Semen from men with mixed infections was excluded from the study. As a control, we used samples of ejaculates from healthy fertile men (n=67, age from 19 to 43 years, average age 25.85.1 years). In the study of the ejaculate, the methods recommended by the WHO expert group were used. In addition to the standard spermogram, MAR tests (IgA, IgG and IgM) were performed, the degree of fragmentation of sperm DNA was evaluated, the interaction of sperm with hyaluronic acid was evaluated, the activity of acrosine, the activity of neutral alpha-glucosidase was determined, the levels of zinc, citric acid, fructose and the level of glycodelin were determined. The study was carried out between 2018 and 2021.
Results: The most common resistance was to erythromycin (88.2%), less often to azithromycin (47.0%), tetracycline (41.7%). Resistance to doxycycline (7.7%), josamycin (5.9%), and medicamycin (5.8%) was relatively rare. In men infected with antibiotic-resistant UU strains from the indicators of the standard spermogram, the most often observed violation of the motor characteristics of spermatozoa asthenozoospermia and violation of the morphology of spermatozoa teratozoospermia. In the presence of polyresistant UU strains, a high degree of sperm DNA fragmentation was more common (10.03% of cases) than in patients with UU strains not resistant to antibiotics (5.92% of cases) or resistant to only one antibiotic (6.16% of cases). Violation of the interaction of spermatozoa with hyaluronic acid was observed more often (more than 12% of cases) in antibiotic-resistant UU strains than in non-antibiotic-resistant UU strains (less than 4% of cases). In men infected with antibiotic-resistant UU strains, a decrease in the enzymatic activity of acrosin was often observed (29.71% of cases), and most often among polyresistant strains (40.46% of cases).