Sexually transmitted infections and semen quality from subfertile men with and without leukocytospermia

Shun Bai,Tonghang Guo,Meiying Sang,Qi Jin,Wenjuan Tang,Xuechun Hu,Ran Liu,Yuanyuan Tao,Yuan Li,Baoguo Xie,Bo Xu,Xiangdong Xu,Qiuling Yue,Wei Li,Yun Zhao,Yangyang Wan

doi:10.1186/s12958-021-00769-2

Abstract

BackgroundThe role of sexually transmitted infections (STIs) in semen parameters and male infertility is still a controversial area. Previous studies have found bacterial infection in a minority of infertile leukocytospermic males. This study aims to investigate the prevalence of STIs in semen from subfertile men with leukocytospermia (LCS) and without leukocytospermia (non-LCS) and their associations with sperm quality.MethodsSemen samples were collected from 195 men who asked for a fertility evaluation. Infection with the above 6 pathogens was assessed in each sample. Sperm quality was compared in subfertile men with and without LCS.ResultsThe LCS group had significantly decreased semen volume, sperm concentration, progressive motility, total motility and normal morphology. The infection rates of Ureaplasma urealyticum (Uuu), Ureaplasma parvum (Uup), Mycoplasma hominis (MH), Mycoplasma genitalium (MG), Chlamydia trachomatis (CT), herpes simplex virus-2 (HSV-2) and Neisseria gonorrhoeae (NG) were 8.7 %, 21.0 %, 8.2 %, 2.1 %, 3.6 %, 1.0 and 0 %, respectively. The STI detection rates of patients with LCS were higher than those of the non-LCS group (52.3 % vs. 39.3 %), although there was no statistically significant difference between the two groups (P = 0.07). All semen parameters were not significantly different between LCS with STIs and without STIs, except the semen volume in the MG-infected patients with LCS was significantly lower than that in the noninfected group.ConclusionsLCS was associated with a reduction in semen quality, but was not associated with STIs.

Highlights

Up to 30 % of infertile men have leukocytospermia which refers to the presence of a high concentration (≥ 1 × 106/ml) of white blood cells (WBCs) in semen [1]
Ureaplasma spp (UU) can be divided into two subtypes, Ureaplasma urealyticum (Uuu) and Ureaplasma parvum (Uup), and studies have shown that Uup is more associated with poor semen quality than Uuu due to differential pathogenicity [14]
We examined the effect of sexually transmitted infections (STIs) pathogenson semen quality in subfertile men with LCS and without LCS using the STD6 GenoArray Diagnostic assay

Summary

Introduction

Up to 30 % of infertile men have leukocytospermia which refers to the presence of a high concentration (≥ 1 × 106/ml) of white blood cells (WBCs) in semen [1]. Leukocytes, including granulocytes (50–60 %), macrophages (20–30 %) and T lymphocytes (2–5 %), have been shown to be a negative factor for semen quality as they induce low sperm motility [2]. Previous studies observed sexually transmitted pathogens in semen in relation to impaired sperm quality and reduced pregnancy rates [8, 9]. Several studies demonstrated that UU increased secondary infertility and reduced sperm quality, including low sperm concentration and motility [11], while other studies did not find a correlation between UU and semen paremeters [12, 13]. The controversial results in previous studies may be due to the lack of discrimination between Uuu and Uup. The role of sexually transmitted infections (STIs) in semen parameters and male infertility is still a controversial area. This study aims to investigate the prevalence of STIs in semen from subfertile men with leukocytospermia (LCS) and without leukocytospermia (non-LCS) and their associations with sperm quality

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Conclusion