Mycoplasma genitalium Provokes Seminal Inflammation among Infertile Males.

Stanislav Tjagur,Kristjan Pomm,Margus Punab,Olev Poolamets,Reet Mändar

doi:10.3390/ijms222413467

Abstract

The impact of sexually transmitted infections (STI) on male fertility is controversial. Aims: To investigate the prevalence of urethritis-associated STIs (chlamydia, gonorrhoeae, Mycoplasma genitalium, trichomoniasis) among infertile males; to analyze the effect of STIs on semen parameters and blood PSA. Case-control study. Study group (n = 2000): males with fertility problems or desire for fertility check. Control group (n = 248): male partners of pregnant women. Analyses: polymerase chain reaction for STI, seminal interleukin 6 (IL-6), semen and fractionated urine, blood analyses (PSA, reproductive hormones). The prevalence of M. genitalium and chlamydia in the study group was 1.1% and 1.2%, respectively. The prevalence of chlamydia in the control group was 1.6%, while there were no M. genitalium cases. No cases with gonorrhoeae or trichomoniasis or combined infections were observed in neither group. There was a higher seminal concentration of neutrophils and IL-6 among M. genitalium positives compared with STI negatives. There was a trend toward a lower total count of spermatozoa and progressive motility among STI positives. No impact of STIs on PSA was found. The prevalence of STIs among infertile males is low. M. genitalium is associated with seminal inflammation. The impact of STIs on semen parameters deserves further investigations.

Highlights

Infertility is defined as the inability of a couple to become pregnant despite unprotected intercourse for a period of more than twelve months [1]
The aim of the current study was to investigate the prevalence of urethritis-associated sexually transmitted infections (STI) (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis) among male patients referring to Andrology Centre (Tartu University Hospital, Tartu, Estonia) due to fertility problems
The abovementioned data and the fact that we found M. genitalium cases only among infertility group patients suggests the role of this bacteria in male impaired fertility and deserves further investigations in larger cohorts or other study populations where the prevalence of STIs is supposed to be higher

Summary

Introduction

Infertility is defined as the inability of a couple to become pregnant despite unprotected intercourse for a period of more than twelve months [1]. Urogenital infections and inflammation are accepted contributing factors of male infertility in 6.9 to 16% of men [4,5]. According to Ochsendorf et al, depending on the local prevalence of STIs and the availability of medical care, the impact of STIs on male urogenital system and fertility (as a consequence of infection) may appear regionally different [7]. Another problem is the distinction of the impact of STI agents between infection with pathological consequences and contamination without relevance [7]. The major drawback of serological tests for C. trachomatis is that a positive antibody test will not distinguish a previous from a current infection [9]

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