Semen Quality of Men With Asymptomatic Chlamydial Infection

Abstract

We have shown previously that the in vitro exposure of spermatozoa to elementary bodies (EBs) of Chlamydia trachomatis can lead to sperm death over a number of hours of incubation. As such, we have hypothesized that the ejaculates of men with a chlamydial infection could contain increased numbers of nonmotile (dead) spermatozoa if they are exposed to EBs prior to ejaculation. To test this hypothesis, the ejaculates of 642 men undergoing diagnostic semen analysis as part of ongoing infertility investigations with their partner were examined. All men were without symptoms of genitourinary infections and semen analysis was performed according to World Health Organisation (WHO) 1999 methods after a 3-5 day abstinence period. In addition to semen analysis, nested plasmid polymerase chain reaction (PCR) was undertaken on the ejaculate to detect the presence of C trachomatis DNA. A total of 31 semen specimens (4.9%) were found to be positive, and in 28 of these, the diagnosis was confirmed using the ligase chain reaction (LCR). Men whose ejaculates were PCR positive for chlamydial DNA had a significantly (P <.05) higher mean concentration of leukocytes (1.71 +/- 2.20 x 10(6) per mL) and a higher mean ejaculate volume (3.45 +/- 1.52 mL) than in those whose ejaculates were PCR negative (leukocyte concentration: 0.67 +/- 2.59 x 10(6) per mL; volume 2.93 +/- 1.38 mL). Leukocytospermia was twice as common in men that were PCR positive for chlamydial DNA (P <.05) but it was not always associated with the presence of chlamydial DNA in semen. However, there was no difference in the mean percent motility between the 2 groups and the proportion of asthenozoospermia also did not differ. Because these results do not confirm the hypothesis proposed from our in vitro experiments, further work needs to be undertaken to understand whether human spermatozoa are actually exposed to elementary bodies of C trachomatis in an infected individual prior to ejaculation.

Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia

“…Our study found CT DNA in semen from 2.5% of infertility patients, with copy numbers ranging from 8,300 to 590,000. This prevalence rate is consistent with earlier publications (32,75,76). CT DNA was associated with a significant decrease in neutral α-glucosidase concentration (and a trend towards lower total sperm and total motile sperm counts).…”

“…However, CT, an intracellular parasite which is the most prevalent sexually transmitted bacterial pathogen in industrialized nations (31), has been associated with LCS. A recent study utilizing nested plasmid polymerase chain reaction (PCR) found both significantly higher seminal WBC concentrations and a greater prevalence of LCS in men who were positive for CT DNA (32).…”

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

“…This assay (LCR) may not be appropriate for the detection of C. trachomatis in semen, which may be due to the fact that semen might contain inhibitory components that interfere negatively with the LCR. However, a recent report by Hosseinzadeh et al (2004) who used the LCR as a confirmatory test for in-house PCR, showed a good correlation between these methods of testing semen.…”

Chlamydial Infection in Urologic Diseases

“…serology versus molecular methods); as well as variable and sometimes inadequate methods to assess semen quality. More recent studies (Hosseinzadeh et al, 2004;Bezold et al, 2007;Al-Mously et al, 2009), using molecular methods to detect infection, and robust methods of laboratory andrology to examine semen, have generally found that men with a current infection of C. trachomatis have poorer quality ejaculates compared than men who do not. It is unclear whether this is because of reduced levels of spermatogenesis in the presence of the bacterium, or whether infection causes an altered ejaculatory response.…”