Orchitis und Infertilität

Abstract

Infections and inflammations of the genital tract are considered the most frequent causes of reduced male fertility, but conclusive epidemiological data are not available. In view of the exposure of germ cells to pathogenic components as well as the cells and mediators involved in the inflammatory processes, irreversible damage to spermatogenesis and corresponding decline of ejaculate quality are to be expected, particularly in cases of chronic orchitis. While the consequences of orchitis and epididymo-orchitis that exhibit clinical symptoms due to systemic or local infections are well known, including testicular atrophy and complete loss of fertility, those cases of inflammatory reactions of the testicles that manifest an asymptomatic or subclinical course, or are not even due to an infection, have received little attention until now. However, systematic histopathological analyses have shown a high prevalence of asymptomatic inflammatory reactions in testicular biopsies from infertile men. The mostly focal lymphocytic infiltrates correlate with the degree of damage to spermatogenesis and corresponding clinical and endocrinological parameters of testicular function. Noninvasive diagnostic techniques are not yet available so that chronic asymptomatic inflammations of the testicles as the primary cause or cofactor of male fertility disorders are underestimated. Except for administration of pathogen-specific antibiotics, treatment recommendations are to a large extent still lacking.

The role of infections and leukocytes in male infertility

“…• Investigation of the role and clinical value of leukocytospermia molecular indications of testicular inflammation with disruption of spermatogenesis can be seen (Klein et al, 2020). It also appears that various immunopathological alterations in the testis play a major role leading to irreversible damage of spermatogenesis (Schuppe & Meinhardt, 2005;Schuppe et al, 2008Schuppe et al, , 2010.…”

Perspective in Pediatric Pathology, Chapter 24. Testicular Inflammatory Processes in Pediatric Patients

“…It is asymptomatic but positive for antisperm antibodies in 100% of patients. Focal orchitis has been observed in adult cryptorchid patients [68], as well as in younger patients consulting for infertility [69][70][71][72][73][74]. In adult cryptorchid patients, the lesions may be tubular or interstitial.…”

Male infertility: the role of imaging in diagnosis and management

“…Despite the absence of conclusive epidemiological data, infections and inflammations of the genital tract are considered the most frequent causes of reduced male infertility [28]. Both clinical and pathological evidence exist to support the theory that chronic inflammatory conditions of the testes disrupt spermatogenesis and irreversibly alter both the number and quality of sperm [28]. Chronic epididymitis and epididymo-orchitis can also result in testicular atrophy.…”