Association between Chlamydia trachomatis Infection and Male Infertility: A Systematic Review and Meta-Analysis.

Abstract

Chlamydia trachomatis infection is one of the most common sexually transmitted diseases. There is widespread evidence in recent years that indicate C. trachomatis infection plays a role in sperm dysfunction and poor sperm quality. However, some controversial documents have argued the role of infection with this bacterium in male infertility. A full comprehensive electronic search was performed using the online databases Web of Science, PubMed, Scopus, Embase, and Google Scholar, without considering the time limits. In the present study, 56 articles were finally found to be eligible. The prevalence of C. trachomatis infection in the infertile males was estimated at 20.6% (19.8-21.5 with 95% CIs; p- Value: 0.01; I2: 97.77; Q-Value: 237.8; p-Value: 0.01; Begg's p-Value: 0.09; Egger's p-Value: 0.01) in overall. We have also shown that infection with C. trachomatis can significantly increase the risk of infertility in men (OR: 2.28; 1.90-2.72 with 95% CIs; p-Value: 0.001; I2: 81.61; QValue: 59.81; p-Value: 0.01; Begg's p-Value: 0.73; Egger's p-Value: 0.61). We showed a high prevalence of C. trachomatis in the sperm and semen samples of infertile men, and C. trachomatis infection is associated with a significantly higher risk of infertility in men.