Association of sexually transmitted infections with semen quality in infertile men using PCR and Flow-Through Hybridization
Sexually transmitted infections with semen quality in infertile men
DOI:
https://doi.org/10.52442/jrmi.v12i2.974Keywords:
Chlamydia trachomatis, Male Infertility, Mycoplasma hominis, Neisseria gonorrhoeae, Semen Analysis, Sexually Transmitted InfectionsAbstract
Introduction: Sexually transmitted infections (STI) are increasingly recognized as a potentially reversible cause of male infertility and may adversely affect semen quality.
Objectives: To determine the prevalence of selected sexually transmitted infections among infertile men and compare semen quality parameters between STI-positive and STI-negative participants.
Methodology: From November 2023 through January 2024, this cross-sectional analytical study was performed at Medicare Cardiac and General Hospital, Karachi Pakistan. Sixty men aged 20–50 years with at least one year of infertility were enrolled. Semen samples after 72 hours of abstinence were collected and examined according to WHO 2021 guidelines. Sexually transmitted pathogens were identified using PCR and flow-through hybridization techniques. Statistical analysis was performed using SPSS version 23, with p<0.05 considered statistically significant.
Results: Sexually transmitted infections were detected in 50% of participants, with Mycoplasma hominis (25%), Chlamydia trachomatis (18.3%), and Neisseria gonorrhoeae (6.7%) being the most frequently identified organisms. Significantly lower sperm concentration (15.2 ± 6.4 vs. 28.5 ± 8.1 million/mL; p<0.001) and progressive sperm motility (28.3% vs. 49.6%; p<0.001) were observed in STI-positive compared with STI-negative participants.
Conclusion: Sexually transmitted infections with poor semen quality parameters were frequently detected among infertile men in this study. These findings suggest that screening for selected sexually transmitted infections may be considered during the evaluation of male infertility.
References
Vallely LM, Egli-Gany D, Wand H, Pomat WS, Homer CSE, Guy R, et al. Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae: systematic review and meta-analysis. Sex Transm Infect. 2021;97(2):104-11. DOI: 10.1136/sextrans-2020-054495.
Boujemaa S, Suri GS, Kaur G. Impact of Mycoplasma hominis on sperm quality among infertile men: a systematic review and meta-analysis. Andrologia. 2025;57(2). DOI: 10.1111/and.14892.
Cheng C, Chen X, Song Y, Wang S, Pan Y, Niu S, et al. Genital mycoplasma infection: a systematic review and meta-analysis. Reprod Health. 2023;20(1):136. DOI: 10.1186/s12978-023-01676-8.
Domrazek K, Kaszak I, Kanafa S, Sacharczuk M, Jurka P. The influence of Mycoplasma species on human and canine semen quality: a review. Asian J Androl. 2023;25(1):29-37. DOI: 10.4103/aja202217.
Rakovskaya I, Ermolaeva S, Gintsburg A, Govorun V. Detection and evaluation of different morphological forms of Mycoplasma hominis in human semen. Andrologia. 2023;55(1). DOI: 10.1111/and.14589.
El Bardisi H, Majzoub A, Arafa M, Al Said S, Khalafalla K, Al Ansari A. Genital tract infections and male infertility: epidemiology and impact on semen quality. Arab J Urol. 2021;19(2):120-7. DOI: 10.1080/2090598X.2021.1929164.
Ventimiglia E, Capogrosso P, Boeri L, Serino A, Colicchia M, Ippolito S, et al. Infertility as a proxy of general male health: results of a cross-sectional survey. Fertil Steril. 2022;117(2):395-403. DOI: 10.1016/j.fertnstert.2021.10.019.
Zhang Y, Xiao L, Xiong C, Li Z, Wang Y, Zhou Z, et al. Association between genital tract infections and semen quality in infertile men: a cross-sectional study. Andrologia. 2022;54(5). DOI: 10.1111/and.14392.
Rowe PJ, Comhaire FH, Hargreave TB, Mahmoud AMA. WHO manual for the standardized investigation, diagnosis and management of the infertile male. Cambridge: Cambridge University Press; 2021.
Wang Y, Li J, Zhang Y, Zhao H, Wang Y, Zhu C, et al. Molecular detection of genital mycoplasmas and their association with semen quality in infertile men. Andrologia. 2021;53(9). DOI: 10.1111/and.14132.
Lwanga SK, Lemeshow S. Sample size determination in health studies: a practical manual. Geneva: World Health Organization; 1991. https://iris.who.int/handle/10665/40062
Gdoura R, Kchaou W, Chaari C, Znazen A, Keskes L, Rebai T, et al. Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis and Mycoplasma genitalium infections and semen quality of infertile men. BMC Infect Dis. 2007;7:129. DOI: 10.1186/1471-2334-7-129.
World Health Organization. WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva: World Health Organization; 2021. https://www.who.int/publications/i/item/9789240030787
Agarwal A, Baskaran S, Parekh N, Cho CL, Henkel R, Vij S, et al. Male infertility. Lancet. 2021;397(10271):319-33. DOI: 10.1016/S0140-6736(20)32667-2.
Salonia A, Bettocchi C, Carvalho J, Corona G, Jones TH, Kadioglu A, et al. EAU guidelines on sexual and reproductive health. Eur Urol. 2021;80(3):333-57. DOI:10.1016/j.eururo.2021.06.007.
Sun H, Gong TT, Jiang YT, Zhang S, Zhao YH, Wu QJ. Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990-2017: results from a global burden of disease study. Aging (Albany NY). 2021;13(7):10952-91. DOI: 10.18632/aging.202739.
Li Y, Wang Y, Xiao L, Xu C, Zhang Y, Wang X, et al. Prevalence of genital mycoplasmas and their association with reproductive tract infections and infertility. BMC Infect Dis. 2022;22(1):214. DOI: 10.1186/s12879-022-07188-4.
Monteiro C, Marques PI, Cavadas B, Damião I, Almeida V, Barros N, et al. Genetic and infectious contributions to male infertility: current understanding and future perspectives. Int J Mol Sci. 2022;23(12):6528. DOI: 10.3390/ijms23126528.
Sunder M, Leslie SW. Semen analysis [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2026 May 18]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK564369/
Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187. DOI: 10.15585/mmwr.rr7004a1.
Xianchun F, Jun F, Zhijun D, Mingyun H. Effects of Ureaplasma urealyticum infection on semen quality and sperm morphology. Front Endocrinol (Lausanne). 2023;14:1113130. DOI: 10.3389/fendo.2023.1113130.
Lotti F, Maggi M. Sexual dysfunction and male infertility. Nat Rev Urol. 2022;19(6):287-307. DOI: 10.1038/s41585-022-00586-4.
Cotter S, Hummel K, Fang M, Kravitz E, Gogia S, Muldrew K, et al. Co-infection of bacterial vaginosis and Mycoplasma genitalium in pregnant women. Am J Obstet Gynecol. 2022;226(2):310. DOI: 10.1016/j.ajog.2021.11.487.
Plummer EL, Vodstrcil LA, Bodiyabadu K, Murray GL, Doyle M, Latimer RL, et al. Are Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum associated with specific genital symptoms and clinical signs in nonpregnant women? Clin Infect Dis. 2021;73(4):659-68. DOI: 10.1093/cid/ciaa1015
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