Genito-urinary tract infections among males: implications for infertility problems in Aba, Abia State, Nigeria

Abstract

Background: Male infertility is an age long socio-medical problem worldwide. It is commonly caused by oligospermia arising from sexually transmitted infections. Assessment of genitourinary tract infections among males with infertility problems may incriminate them (infections) as possible risk factors for male infertility in Aba, Nigeria. Objective: To determine prospectively in male subjects with infertility problems the potential impact of urogenital tract infections. Design: Prospective study. Setting: Gynaecology Clinic, Abia State University Teaching Hospital, Aba, Nigeria. Subjects: Three hundred and ninety six men with infertility problem attending Gynecology Clinic with their spouses at Abia State University Teaching Hospital, Aba. Methods: Semen and blood specimen were collected from 396 men who were unable to achieve conceptions with their spouses 5-8 years after marriage. Each semen sample was evaluated for sperm cell count and cultured bacteriologically for isolation of genito-urinary tract pathogens; while the blood samples were tested serologically for Treponema pallidium (syphilis) and HIV infections. Results: Of the 396 semen samples, 205(51.5%) had normal sperm counts, 63(15.8%) had no sperm cells (azoospermia) and 63(15.8%) had mean sperm cell count of 6.5 ± 1.3 x 106 sperm cell/ml; range, 0.1-19.9 x 106 (oligospermia). Among the males with normal sperm counts 4(0.8%) were infected with HIV, 1(0.5%) with syphilis, 2(1.0%) with E. coli and 37(18.1%) with S. aureus ; while among the azoospermia and oligospermia cases, respectively, distributions of the infections were HIV (14.3%, 3.9%), syphilis (7.9%, 2.3%), S. aureus (46.0%, 12.3%), S. pyogenes (30.2%, 5.4%) and E. coli (3.7%, 3.1%). Of the 118 bacterial strains tested for antibiotic susceptibility (117 isolates and 1 typed S. aureus ATCC 25923, control strain), 3.4% were resistant to ofloxacin (OXF), 21.2% to gentamycin (CN), 5.1% to ciprofloxacin (CPF), 25.4% to cefuroxime (CXM), 88.4% to erythromycin (E), and 99.15% to ampicillin and streptomycin, respectively. The control strain, S. aureus ATCC 25923, was susceptible to all the drugs. Conclusion: The adjudged infertile males (48.7%) in this finding may have arisen on account of the genitourinary and syphyllis infections encountered among men with oligospermia and azoospermia.