Introduction. When assessing the urogenital tract microbiome in both men and women, modern clinical
guidelines suggest using the real-time polymerase chain reaction method, which allows qualitatively and
quantitatively identifying the microbiota of sexual partners. The urogenital tract microbiome of a married couple
remains poorly understood. The impact of the urogenital tract microbiota of sexual partners and the possibility
of transmitting it to each other also remains open. To date, there are no clear recommendations on which of the
biotopes in men to choose primarily for verification of microorganisms, while one of the possible biotopes is
most often examined. In our previously published works, we noted that the biotopes of the urethra, prostate
secretion and ejaculate in men have a low level of concordance among themselves, and the biotopes of the
urogenital tracts of sexual partners in most cases do not coincide, which calls into question the daily practice
of prescribing treatment to both spouses at the same time, having data from only one of them. The role of male
factors in the development of bacterial vaginosis in the spouse remains debatable to this day. Modern advances
in molecular diagnostics have made it possible to consider bacterial vaginosis as a probable sexually transmitted
infection, including the spouse.
Material and methods: а survey of 127 married couples who sought help for pre-conception preparation,
infertility or miscarriage was conducted, and then divided into two groups. The first group, «Normocenosis»,
consisted of 67 married couples in whom the proportion of Lactobacillus spp. was determined to be 80-100% of
the cervical canal microflora. The second group, «Dysbiosis», consisted of 60 couples in whom the proportion
of Lactobacillus spp. was determined to be lower than 80% of the total cervical canal microflora, which
corresponded to the diagnosis of BV. The biotopes of the cervical canal of women, the urethra and ejaculate of
men were analyzed by the PCR real-time method using the «Androflor®» and «Femoflor®» reagent kits («DNATechnology TS», Russia).
Results. The biotope of the ejaculate had statistically lower values of the total bacterial mass, compared with
the urethra and cervical canal. In the biotope of the cervical canal, Gardnerella vaginalis/Prevotella bivia/
Porphyromonas spp. and Ureaplasma spp. were found significantly more often compared with the biotope
of both the urethra and the ejaculate of men. In the urethra of men, Staphylococcus spp., Streptococcus
spp., Eubacterium spp. and Peptostreptococcus spp. were identified more often than the cervical canal.
Eubacterium spp. were determined significantly more often in the ejaculate, compared with the cervical canal.
The occurrence of Enterobacteriaceae/Enterococcus spp. in the urethra and in the sperm was reliably higher
compared with the cervical canal. The concordance for all bacteria detected in the compared biotopes of the
spouses did not exceed 34%. The concordance for Gardnerella vaginalis and Ureaplasma spp. was significantly
higher between the biotopes of the cervical canal and urethra, compared with the concordance between the
cervical canal and ejaculate. In the «Normocenosis» group, Ureaplasma spp. and Enterobacteriaceae spp. were
encountered significantly less frequently in the cervical canal compared with the «Dysbiosis» group. In men,
Staphylococcus spp. and Gardnerella vaginalis were detected significantly more often in the ejaculate of the
«Dysbiosis» group compared with the «Normocenosis» group. In the ejaculate of men from the «Dysbiosis»
group, an increase in the total bacterial mass was encountered significantly more often compared with the
«Normocenosis» group.
Conclusion. In our opinion, in men with infertility and/or miscarriage, it is necessary to evaluate the
biotope of both the urethra and the ejaculate, because the biotopes of the spouse’s cervical canal, urethra and
ejaculate have a low percentage of concordance, which must be taken into account when diagnosing and treating
urogenital tract infections of sexual partners.
