Immunology: Chlamydial immunoglobulin IgG and IgA antibodies in serum and semen are not associated with the presence of Chlamydia trachomatis DNA or rRNA in semen from male partners of infertile couples

Abstract

The role of Chlamydia (C.) trachomatis in male infertility is controversial. The objective of this study was to determine the prevalence of asymptomatic C. trachomatis infections in male partners of infertile couples, and to compare this result with the presence of chlamydial antibodies in serum and semen. C.trachomatis was detected in five of 50 semen specimens (10%) by either polymerase chain reaction for C. trachomatis DNA or direct DNA probing for C. trachomatis rRNA. There was no association between the detection of C. trachomatis in semen and the presence of chlamydial antibodies in serum or semen. Chlamydial serum antibodies were neither associated with antiserum serum antibodies nor with pathological standard semen parameters. These results indicate that the assessment of chlamydial immunoglobulin IgG and IgA antibodies in serum or semen is of limited use in male infertility work-up, in contrast to its significance in female tubal infertility. The presence of C. trachomatis in semen emphasizes the potential risk of transmission during artificial insemination and other assisted reproductive techniques, and underlines the importance of sensitive direct detection methods in this group of patients.

Assessment of Chlamydia trachomatis infection in asymptomatic male partners of infertile couples

“…The presence of C. trachomatis in semen emphasizes the potential risk of this route of transmission, and underlines the need for sensitive direct detection methods in this group of patients (Dieterle et al, 1995).…”

“…It is important to resolve this issue, since chlamydiae present in semen could be transmitted by adhering to spermatozoa, which may serve as vectors, spreading the pathogen to the uterus and Fallopian tubes. In fact, studies have reported finding spermatozoa with adhering chlamydial bodies in the peritoneal fluid of women with salpingitis at laparoscopy (Friberg et al, 1987).The presence of C. trachomatis in semen emphasizes the potential risk of this route of transmission, and underlines the need for sensitive direct detection methods in this group of patients (Dieterle et al, 1995).Screening with classical cell culture requires specimens from endo-urethral swabs, which are unacceptable to many asymptomatic men. The cell culture method cannot be used for semen and urine samples due to their cytotoxicity (Mardh et al, 1980), and is not sufficiently sensitive to rule out infections of accessory glands (Berger et al, 1978).…”

IgA ANTIBODIES TOCHLAMYDIA TRACHOMATISAND SEMINAL PARAMETERS IN ASYMPTOMATIC INFERTILE MALES

“…The differences may be due in part to the type of study carried out in these populations, different diagnostic tests, or different preparation of samples [25]. The effect of C. trachomatis on male fertility is not yet established, since infected men do not show alterations in semen analysis [9,11,12]. On the other hand, C. trachomatis may adhere to and penetrate the sperm, causing infection and, later on, infertility by decreasing motility and/or sperm count [10].…”

“…The female reproductive tract can be colonized by this microorganism during sexual intercourse and assisted reproduction procedures and this infection may cause infertility [3,9,11,12,33]. Although the presence of IgA antibodies to C. trachomatis in semen is not associated with alterations in seminal parameters or inflammatory response in male reproductive tract, these antibodies could indicate a risk factor for STD for couples of asymptomatic infertile men.…”

“…However, it is controversial whether or not asymptomatic genital infection may cause male infertility. This may be due to the difficulties in diagnosing the microorganism, since antigens are not usually detected in semen, and IgA and IgC serodiagnosis has a low reproducibility rate in acute infection [9,25,31,35]. Antichlamydial IgA detection in seminal plasma is a highly specific test for C. trachomatis diagnosis that has good agreement with other speciesspecific methods, such as ELISA, and more sensitivity than microimmunofluorescence [4,25].…”