Infertility can be attributed to reproductive tract infections (RTI), most commonly nongonococcal urethritis, mainly including Mycoplasma and Chlamydia infections, which may directly or indirectly damage spermatozoa and spermatogenic cells. In addition, a series of immune responses caused by such infections are also associated with male infertility. Methods for the clinical detection of these microbial infections are being constantly improved for more specific and precise control over the impact of Mycoplasma and Chlamydia infections on male fertility.
Chlamydia Infections ; complications ; Humans ; Infertility, Male ; microbiology ; Male ; Mycoplasma ; Mycoplasma Infections ; complications ; Reproductive Tract Infections ; Spermatozoa ; microbiology ; Urethritis ; complications ; microbiology

ObjectiveTo explore Mycoplasma genitalium (MG) infection in the urogenital tract of infertile men and its influence on semen quality.

METHODSSemen samples were collected from 352 infertile males in the Center of Reproductive Medicine of Nanjing General Hospital from March to July 2015. MG infection was detected by real-time fluorescence simultaneous amplification and testing and semen analyses were conducted according to the WHO Laboratory Manual for the Examination and Processing of Human Semen (5th Ed) on the semen pH value, semen volume, total sperm count, sperm concentration, total sperm motility, percentages of progressively motile sperm (PMS) and immotile sperm (IMS), and sperm DNA fragmentation index (DFI). The data obtained were subjected to statistical analysis by t-test and non-parametric test (Wilcoxon test).

RESULTSMG infection was found in 3.4% (12/352) of the infertile patients. Compared with the MG-positive cases, the MG-negative ones showed a significantly higher semen volume (［2.85 ± 0.14］ vs ［3.84 ± 0.12］ ml, P = 0.008) and percentage of PMS (［15.86±1.72］ vs ［60.95 ± 5.63］ %, P = 0.032) but a lower DFI (［30.73 ±2.24］ vs ［20.71 ± 1.55］%, P = 0.014). However, no statistically significant differences were observed between the two groups in the semen pH value (7.38 ±0.02 vs 7.39 ± 0.01, P = 0.774), sperm concentration (［52.96 ± 15.78］ vs ［60.05 ± 4.29］×10⁶/ml, P = 0.683), sperm count (［154.15 ± 46.37］ vs ［221.56 ± 15.43］×106, P = 0.236), total sperm motility (［29.04 ± 3.11］ vs ［33.52 ± 1.51］ %, P = 0.626), or percentage of IMS (［23.57 ± 0.99］ vs ［62.34 ± 1.69］ %, P = 0.691).

CONCLUSIONSUrogenital MG infection is common in infertile males and potentially affects the semen quality, especially sperm vitality of the patient.

DNA Fragmentation ; Humans ; Infertility, Male ; microbiology ; physiopathology ; Male ; Male Urogenital Diseases ; microbiology ; Mycoplasma Infections ; complications ; Mycoplasma genitalium ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; physiology

OBJECTIVETo investigate the correlation between Ureaplasma urealyticum infection and infertility in Chinese males.

METHODSAccording to the results of the heterogeneity test, a comprehensive quantitative analysis was made of 49 papers on Ureaplasma urealyticum infection and Chinese male infertility by RevMan 4.2.2. The impacts of different sample volumes on the research findings were compared, and the sensitivities of culture and PCR detections analyzed respectively.

RESULTSUreaplasma urealyticum had a significant negative impact on Chinese male fertility. Based on different samples of literature, two rounds of screening and analysis were carried out and two different conclusions derived. The first was OR = 4.43 (95% CI: 3.77-5.22), with the OR values of culture and PCR detections as 4.25 (95% CI: 3.59-5.03) and 5.35 (95% CI: 3.37-8.47), and the second was OR = 4.28 (95% CI: 3.52-5.20), with the OR values of culture and PCR detections as 4.24 (95% CI: 3.41-5.28) and 4.42 (95% CI: 2.73-7.17).

CONCLUSIONThere is a significant correlation between Ureaplasma urealyticum and Chinese male infertility. The conclusion of study is significantly influenced by the sample volume, which should be reasonably designed. The sensitivity of PCR detection is higher than that of culture detection.

China ; epidemiology ; Humans ; Infertility, Male ; epidemiology ; Male ; Polymerase Chain Reaction ; Ureaplasma Infections ; epidemiology ; microbiology ; Ureaplasma urealyticum ; genetics ; isolation & purification

Objective: To analyze the relationship of Mycoplasma genitalium (MG) infection with routine semen parameters and sperm DNA integrity in male infertility patients. METHODS: Totally, 114 semen samples, 34 MG-positive and 80 MG-negative, were collected from male infertility patients and subjected to routine semen analysis with the computer-assisted sperm analysis system, Papanicolaou staining for observation of sperm morphology, and sperm chromatin diffusion (SCD) test for detection of sperm DNA integrity. Semen parameters and DNA integrity were compared between the MG-positive and MG-negative groups with SPSS 21.0 statistical software and the relationship between the semen parameters and DNA integrity analyzed by Pearson correlation analysis. RESULTS: The MG-positive samples, compared with the MG-negative ones, showed significantly decreased semen volume (［2.87 ± 0.37］ vs ［3.86 ± 0.43］ ml, P < 0.01), sperm concentration (［29.05 ± 6.17］ vs ［32.56 ± 5.97］ ×10⁶/ml, P < 0.01), and percentages of progressively motile sperm (PMS) (［15.86 ± 2.79］% vs ［23.65 ± 3.47］%, P < 0.01) and morphologically normal sperm (MNS) (［6.35 ± 2.06］% vs ［7.14 ± 1.89］%, P < 0.05), increased proportions of non-halo sperm (［15.02 ± 3.52］% vs ［9.72 ± 2.94］%, P <0.01) and small-halo sperm (［16.37 ± 5.26］% vs ［11.07 ± 1.65］%, P < 0.01) and sperm DNA fragmentation index (DFI) (［31.39 ± 3.16］% vs ［20.79 ± 3.59］%, P < 0.01), and reduced proportion of large-halo sperm (［54.75 ± 8.74］% vs ［64.15 ± 9.76］%, P < 0.01). DFI was negatively correlated with the percentages of PMS (r = －0.516, P < 0.05) and MNS (r = －0.429, P < 0.05) in the MG-positive group, but not correlated with any of the routine semen parameters in the MG-negative patients (P > 0.05). CONCLUSIONS MG infection may be an important factor affecting sperm quality in male infertility patients. Active prevention and treatment of MG infection can help prevent male infertility.
DNA Fragmentation ; Humans ; Infertility, Male/microbiology* ; Male ; Mycoplasma Infections/complications* ; Mycoplasma genitalium ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa

OBJECTIVETo investigate the impact of Staphylococcus aureus from infertile men on sperm motility and the relationship between virulence genes and the activity of spermatozoal immobilization.

METHODSWe collected 60 strains of non-repeated Staphylococcus aureus from the semen of 589 infertile males and analyzed the influence of Staphylococcus aureus on sperm motility using the computer-aided sperm analysis system. We selected the strains that apparently decreased sperm motility and detected their virulence genes by PCR.

RESULTSSperm motility was significantly decreased in 17 of the 60 strains of Staphylococcus aureus (P < 0.05). The main virulence genes in these strains were hlg (33.3%), scn (23.3%), cna (20%), hlb (20%), and clfA (18.3%), others including icaA, fnbA, tst, seb, hld, eta and sea. The scn gene carriers accounted for 47.1% in the spermatozal immobilization positive group, significantly higher than 14% in the negative group (P < 0.05). No statistically significant differences were found in the percentages of the carriers of the other virulence genes between the two groups (P > 0.05).

CONCLUSIONInfections of Staphylococcus aureus in male reproductive system can lead to the decrease of sperm motility, which may be associated with the Staphylococcus complement inhibitor encoding gene scn.

Humans ; Infertility, Male ; microbiology ; Male ; Polymerase Chain Reaction ; Semen ; microbiology ; Species Specificity ; Sperm Motility ; Staphylococcal Infections ; Staphylococcus aureus ; pathogenicity ; Virulence ; genetics

OBJECTIVETo investigate the status of the semen of the infertility patients infected by Gardnerella vaginalis (Gv).

METHODSSemen samples from 373 clinic patients of infertility and vaginal samples from 63 positive patients' wives were collected from April 2002 to May 2003. And the samples were tested by nested polymerase chain reaction (nPCR).

RESULTSThe positive rate of the infertile males' semen infected by Gv was 44.2%, while that of the postive patients' wives was 87.3%.

CONCLUSIONThe positive rate of the infertile male's semen infected by Gv is high and Gv can be spread by sexual intercourse.

Adult ; Base Sequence ; Female ; Gardnerella vaginalis ; isolation & purification ; Humans ; Infertility, Male ; microbiology ; Male ; Molecular Sequence Data ; Polymerase Chain Reaction ; Semen ; microbiology

Objective: To investigate the value of real-time RNA simultaneous amplification and testing (SAT) in the detection of Ureaplasma urealyticum (UU) in the semen of infertile males and its clinical significance. METHODS: We collected semen samples from 542 infertility patients and 120 normal fertile men as controls in the Andrology Clinic of Nanjing General Hospital from March to September 2015. We detected UU infection in the samples using the culture method and SAT technology, respectively. RESULTS: All the UU positive cases (except 4 false positive cases) detected by the culture method were also shown to be positive in SAT. The UU detection rate of SAT was significantly higher than that of the culture method both in the infertility patients (54.1 vs 19.7%, P<0.05) and in the normal controls (42.5 vs 12.5%, P<0.05). CONCLUSIONS SAT is a rapid and accurate method for detecting UU infection in semen samples, with a higher sensitivity and accuracy than the culture method, and it can also be used to evaluate the therapeutic effects. However, the culture method has its own advantages, such as low requirement of technical equipment, easy operation, and possibility of drug sensitivity test at the same time. Therefore, SAT and the culture method can be used alternatively according to the clinical need.
Andrology ; Humans ; Infertility, Male ; microbiology ; Male ; Nucleic Acid Amplification Techniques ; RNA, Bacterial ; analysis ; Semen ; chemistry ; microbiology ; Semen Analysis ; Ureaplasma Infections ; diagnosis ; Ureaplasma urealyticum ; genetics ; isolation & purification

OBJECTIVETo investigate the influence of Ureaplasma urealyticum (Uu) infection in the male reproductive tract on the outcomes of IVF and the clinical significance of preoperative Uu test by analyzing the correlation between the results of Uu culture before IVF-ET and the outcomes of IVF-ET.

METHODSAmong 1,059 couples undergoing IVF-ET, we selected 973 after excluding genetic factors and divided them into a Uu negative and a Uu positive group according to the results of culture of Uu in the semen of the males. We compared the rates of IVF fertilization, oocyte cleavage, clinical pregnancy and abortion between the two groups, and analyzed the influence of Uu infection on IVF outcomes.

RESULTSAmong the 973 selected subjects, 836 were Uu negative (group A) and 137 Uu positive (group B), and of the latter, 130 were restored to Uu negative after treatment (group B1) and the other 7 remained unchanged (group B2). No significant differences were found between groups A and B in the rates of IVF fertilization (81.6% vs 79.8%, P = 0.13), abnormal fertilization (11.8% vs 12.4%, P = 0.58) and oocyte cleavage (92.0% vs 92.1%, P = 0.94), nor between groups A and B2 (81.6% vs 89.8%, P = 0.10; 11.8% vs 13.2%, P = 0.75; 92.0% vs 92.5%, P = 0.10). Totally, 747 of the patients underwent embryo transfer, including 643 in group A and 104 in group B. There were no significant differences between groups A and B in the rates of clinical pregnancy (38.6% vs 34.7%, P = 0.44) and abortion (16.5% vs 22.2%, P = 0.39), nor between groups A and B2 (38.6% vs 33.3%, P = 0.79; 16.5% vs 0, P = 0.53).

CONCLUSIONUu infection in the male reproductive tract does not significantly affect the rates of IVF fertilization, oocyte cleavage, clinical pregnancy and abortion. However, more investigations with larger sample sizes of the cases restored from Uu positive to Uu negative are needed to lend further support to our findings.

Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Genitalia, Male ; microbiology ; Humans ; Infertility, Male ; microbiology ; therapy ; Male ; Male Urogenital Diseases ; epidemiology ; microbiology ; Middle Aged ; Pregnancy ; Pregnancy Rate ; Ureaplasma Infections ; epidemiology ; Ureaplasma urealyticum

OBJECTIVETo understand Ureaplasma urealyticum (Uu) infection, analyzed the influence of Uu infection on the seminal quality and the accessory genetical gland function in male infertility patients, and investigate its mechanism.

METHODSWe cultured 202 semen samples collected from male infertility patients and analyzed the influence of Uu infection on seminal parameters and the biochemical indexes of the seminal plasma.

RESULTSThe Uu infection rate was 33.7% in the infertile males, with no statistic differences between the Uu positive and negative groups either in the average age (28.9 +/- 4.7 yrs vs 29.6 +/- 4.0 yrs, P = 0.250) or in the seminal quantity (2.93 +/- 1.32 ml vs 2.86 +/- 1.52 ml, P = 0.774). The sperm density, motility and vitality were (84.37 +/- 52.92) x 10(6) ml, (44.62 +/-22.13) % and (38.40 +/- 15.61) % in the Uu positive group, significantly lower than (101.90 +/- 43.90) x 10(6) ml, (51.83 +/- 19.88) % and (44.45 +/- 15.47) % in the Uu negative group (P = 0.025, P = 0.036 and P = 0.020). The seminal pH value was normal in both of the groups, but significantly higher in the Uu positive than in the negative group (7.32 +/- 0.10 vs 7.19 +/- 0.29, P = 0.003). VCL, VSL, VAP and MAD were significantly lower, while BCF was significant higher in the former than in the latter [(33.97 +/- 8.96) microm/s vs (39.70 +/- 8.14) microm/s, t = 4.113, P < 0.001; (22.29 +/- 6.06) microm/s vs (25.20 +/- 6.67) microm/s, t = 2.684, P = 0.008; (25.96 +/- 6.83) microm/s vs (30.02 +/- 6.81) microm/s, t = 3.537, P < 0.001; 46.60 +/- 13.68 vs 54.23 +/- 15.14, t = 3.112, P = 0.002; (6.12 +/- 1.89) Hz vs (5.22 +/- 1.64) Hz, t = 3. 164, P = 0.002]. All the five indexes were influenced by Uu infection. Compared with the negative group, the seminal plasma alpha-glucosidase was significantly decreased in the positive group [(40.0 +/-18.7) U/ml vs (47.9 +/- 21.0) U/ml, t = 2.248, P = 0.026], and the risk of the decrease was 2.12 times higher. No statistic difference was observed in seminal plasma acid phosphatase and seminal plasma fructose between the two groups.

CONCLUSIONUu infection in the genital tract is an important factor of seminal quality reduction in infertile men and may cause a decreased secretion of alpha-glucosidase in the epididymis, but it hardly influences the prostate and seminal vesicle.

Adult ; Genital Diseases, Male ; microbiology ; physiopathology ; Humans ; Infertility, Male ; physiopathology ; Male ; Middle Aged ; Semen ; cytology ; metabolism ; microbiology ; Sperm Count ; Sperm Motility ; Ureaplasma Infections ; microbiology ; physiopathology ; Ureaplasma urealyticum ; isolation & purification ; alpha-Glucosidases ; metabolism

OBJECTIVESTo evaluate the clinical significance of the detection of IgG and IgM antibodies against Chlamydia trachomatis (CT) in semen of asymptomatic infertile patients.

METHODSOne hundred and sixteen asymptomatic infertile patients and eighteen fertile males were selected randomly. The routine parameter analysis of semen was fulfilled by computer aided semen analysis(CASA). Then the seminal plasma was separated and the IgG, IgM antibodies against CT in seminal plasma were determined with ELISA method.

RESULTSIgG and IgM antibodies against CT were present in 13.8% (16/116) and 3.4% (4/116) of the semen of infertile patients, while for the fertile males the percentages were 11.1% (2/18) and 0, respectively. There were no differences between the two groups(P > 0.05). In the infertile patients, 22 patients were azoospermia. And in the rest 94 infertile patients, the percentages of IgG and IgM antibodies in abnormal sperm density group were 21.4% (6/28) and 7.1% (2/28), which were higher than those in normal group, but there were no statistical differences(P > 0.05). Similarly, the IgG, IgM antibodies were not correlated with the sperm motility(P > 0.05). The positive percentage of CT in 116 patients was 25.9% (30/116).

CONCLUSIONSThe percentages of IgG and IgM antibodies against CT in semen of asymptomatic infertile patients are similar to that in fertile males, which do not correlate with the changes of semen parameters, and may not be used for indication of CT infection.

Adult ; Antibodies, Bacterial ; blood ; Chlamydia trachomatis ; immunology ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Infertility, Male ; microbiology ; Male ; Sperm Count ; Sperm Motility