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Heidari Pebdeni, P., Saffari, F., Reza Mirshekari, T., Ashourzadeh, S., Taheri Soodejani, M., & Ahmadrajabi, R. (2022). Bacteriospermia and its association with seminal fluid parameters and infertility in infertile men, Kerman, Iran: A cross-sectional study. International Journal of Reproductive BioMedicine (IJRM), 20(3), 203-212. https://doi.org/10.18502/ijrm.v20i3.10712
https://doi.org/10.18502/ijrm.v20i3.10712
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Parastou Heidari Pebdeni
Parastou Heidari Pebdeni
Department of Medical Microbiology (Bacteriology & Virology), Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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Fereshteh Saffari
Fereshteh Saffari
Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
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Toraj Reza Mirshekari
Toraj Reza Mirshekari
Afzalipour Clinical Center for Infertility, Kerman University of Medical Sciences, Kerman, Iran.
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Sareh Ashourzadeh
Sareh Ashourzadeh
Afzalipour Clinical Center for Infertility, Kerman University of Medical Sciences, Kerman, Iran.
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Moslem Taheri Soodejani
Moslem Taheri Soodejani
Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Roya Ahmadrajabi
Roya Ahmadrajabi
Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Published Date
- Apr 21, 2022
Bacteriospermia and its association with seminal fluid parameters and infertility in infertile men, Kerman, Iran: A cross-sectional study
Abstract
Background: The role of genital Ureaplasma species, genital Mycoplasma (M) species, and Chlamydia (C.) trachomatis, the most prevalent sexually transmitted bacteria, in male infertility are still not clear. Different reports about the impact of these bacteria on semen quality are controversial.
Objective: This study was proposed to determine the frequency of bacteriospermia in men and investigate the relationship between the presence of these bacteria and semen quality using molecular assay.
Materials and Methods: In this cross-sectional study, 200 semen samples obtained from men attending the research and clinical centers for fertility in Kerman, Iran, between July and December 2019 were analyzed for semen volume, progressive motility, nonprogressive motility, total progressive motility, and viability according to the World Health Organization guidelines. The polymerase chain reaction was used for the detection of related bacteria.
Results: The mean values of volume, progressive motility, non-progressive motility, total progressive motility, and viability were significantly lower in infertile men (p < 0.001). Statistically significant correlations were observed between the presence of M. genitalium and progressive sperm motility, M. hominis and semen volume, Ureaplasma parvum and the sperm normal form, and C. trachomatis and the sperm progressive motility and viability. Logistic regression analysis showed that M. genitalium (OR = 8.06, p < 0.001) and C. trachomatis (OR = 16, p = 0.01) were significantly associated with male infertility.
Conclusion: During the infertility assessment, clinicians should consider the role of C. trachomatis and M. genitalium in male infertility. Screening test particularly for asymptomatic individuals is recommended.
Key words: Chlamydia trachomatis, Infertility, Mycoplasma, Semen analysis, Ureaplasma.
References
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[2] Abusarah EA, Awwad ZM, Charvalos E, Shehabi AA. Molecular detection of potential sexually transmitted pathogens in semen and urine specimens of infertile and fertile males. Diagn Microbiol Infect Dis 2013; 77: 283– 286.
[3] Nwankwo EO, Sadiq MN. Prevalence of Chlamydia trachomatis infection among patients attending infertility and sexually transmitted diseases clinic (STD) in Kano, North Western Nigeria. Afr Health Sci 2014; 14: 672–678.
[4] Eley A, Pacey AA, Galdiero M, Galdiero M, Galdiero F. Can Chlamydia trachomatis directly damage your sperm? Lancet Infect Dis 2005; 5: 53–57.
[5] Ahmadi MH, Mirsalehian A, Bahador A. Prevalence of genital Chlamydia trachomatis in Iran: A systematic review and meta-analysis. Pathog Glob Health 2015; 109: 290– 299.
[6] Al-Sweih NA, Al-Fadli AH, Omu AE, Rotimi VO. Prevalence of Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium and Ureaplasma urealyticum infections and seminal quality in infertile and fertile men in Kuwait. J Androl 2012; 33: 1323–1329.
[7] Rybar R, Prinosilova P, Kopecka V, Hlavicova J, Veznik Z, Zajicova A, et al. The effect of bacterial contamination of semen on sperm chromatin integrity and standard semen parameters in men from infertile couples. Andrologia 2012; 44: 410–418.
[8] Gdoura R, Kchaou W, Ammar-Keskes L, Chakroun N, Sellemi A, Znazen A, et al. Assessment of Chlamydia trachomatis, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis and Mycoplasma genitalium in semen and first void urine specimens of asymptomatic male partners of infertile couples. J Androl 2008; 29: 198–206.
[9] Zhou YH, Ma HX, Shi XX, Liu Y. Ureaplasma spp. in male infertility and its relationship with semen quality and seminal plasma components. J Microbiol Immunol Infect 2018; 51: 778–783.
[10] Zeighami H, Peerayeh SN, Yazdi RS, Sorouri R. Prevalence of Ureaplasma urealyticum and Ureaplasma parvum in semen of infertile and healthy men. Int J STD AIDS 2009; 20: 387–390.
[11] Maleki S, Motamedi H, Moosavian SM, Shahbaziyan N. Frequency of Mycoplasma hominis and Ureaplasma urealyticum in females with urogenital infections and habitual abortion history in Ahvaz, Iran, using multiplex PCR. Jundishapur J Microbiol 2013; 6: 1–5.
[12] Ramazanzadeh R, Khodabandehloo M, Farhadifar F, Rouhi S, Ahmadi A, Menbari S, et al. A case-control study on the relationship between Mycoplasma genitalium infection in women with normal pregnancy and spontaneous abortion using polymerase chain reaction. Osong Public Health Res Perspect 2016; 7: 334–338.
[13] Huang C, Zhu HL, Xu KR, Wang SY, Fan LQ, Zhu WB. Mycoplasma and Ureaplasma infection and male infertility: A systematic review and meta-analysis. Andrology 2015; 3: 809–816.
[14] Bachir BG, Jarvi K. Infectious, inflammatory, and immunologic conditions resulting in male infertility. Urol Clin North Am 2014; 41: 67–81.
[15] Ahmadi MH, Mirsalehian A, Bahador A. Prevalence of urogenital mycoplasmas in Iran and their effects on fertility potential: A systematic review and meta-analysis. Iran J Public Health 2016; 45: 409–422.
[16] Ahmadi A, Ramazanzadeh R, Sayehmiri K, Sayehmiri F, Amirmozafari N. Association of Chlamydia trachomatis infections with preterm delivery: A systematic review and meta-analysis. BMC Pregnancy Childbirth 2018; 18: 240– 246.
[17] Janghorban R, Azarkish F. An overview on sexually transmitted infections in Iran. Int J Reprod Contracept Obstet Gynecol 2016; 5: 585–595.
[18] Moosavian M, Ghadiri A, Amirzadeh S, Rashno M, Afzali M, Ahmadi K. Investigating Chlamydia trachomatis and genital Mycoplasma prevalence and apoptosis markers in infertile and fertile couples. Jundishapur J Microbiol 2019; 12: e84954.
[19] Mohseni Moghadam N, Kheirkhah B, Mirshekari TR, Fasihi Harandi M, Tafsiri E. Isolation and molecular identification of Mycoplasma genitalium from the secretion of genital tract in infertile male and female. Iran J Reprod Med 2014; 12: 601–608.
[20] Safavifar F, Bandehpour M, Hosseiny SJ, Khorramizadeh MR, Shahverdi A, Kazemi B. Mycoplasma infection in pyospermic infertile and healthy fertile men. Novel Biomed 2015; 3: 25–29.
[21] Lee JSh, Kim KT, Lee HS, Yang KM, Seo JT, Choe JH. Concordance of Ureaplasma urealyticum and Mycoplasma hominis in infertile couples: Impact on semen parameters. Urology 2013; 81: 1219–1224.
[22] Günyeli I, Abike F, Dünder I, Aslan C, Tapısız ÖL, Temizkan O, et al. Chlamydia, Mycoplasma and Ureaplasma infections in infertile couples and effects of these infections on fertility. Arch Gynecol Obstet 2011; 283: 379– 385.
[23] Liu J, Wang Q, Ji X, Guo S, Dai Y, Zhang Z, et al. Prevalence of Ureaplasma urealyticum, Mycoplasma hominis, Chlamydia trachomatis infections, and semen quality in infertile and fertile men in China. Urology 2014; 83: 795–799.
[24] 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: 129–137.
[25] Plecko V, Zele-Starcevic L, Tripkovic V, Skerlev M, Ljubojevic S, Plesko S, et al. Unusually low prevalence of Mycoplasma genitalium in urine samples from infertile men and healthy controls: A prevalence study. BMJ Open 2014; 4: e005372.
[26] Ouzounova-Raykova V, Ouzounova I, Mitov I. Chlamydia trachomatis infection as a problem among male partners of infertile couples. Andrologia 2009; 41: 14–19.
[27] Mazzoli S, Cai T, Addonisio P, Bechi A, Mondaini N, Bartoletti R. Chlamydia trachomatis infection is related to poor semen quality in young prostatitis patients. Eur Urol 2010; 57: 708–714.
[28] Rose BI, Scott B. Sperm motility, morphology, hyperactivation, and ionophore-induced acrosome reactions after overnight incubation with mycoplasmas. Fertil Steril 1994; 61: 341–348.
[29] Deguchi T, Shimada Y, Horie K, Mizutani K, Seike K, Tsuchiya T, et al. Bacterial loads of Ureaplasma parvum contributes to the development of inflammatory responses in the male urethra. Int J STD AIDS 2015; 26: 1035–1039.
[2] Abusarah EA, Awwad ZM, Charvalos E, Shehabi AA. Molecular detection of potential sexually transmitted pathogens in semen and urine specimens of infertile and fertile males. Diagn Microbiol Infect Dis 2013; 77: 283– 286.
[3] Nwankwo EO, Sadiq MN. Prevalence of Chlamydia trachomatis infection among patients attending infertility and sexually transmitted diseases clinic (STD) in Kano, North Western Nigeria. Afr Health Sci 2014; 14: 672–678.
[4] Eley A, Pacey AA, Galdiero M, Galdiero M, Galdiero F. Can Chlamydia trachomatis directly damage your sperm? Lancet Infect Dis 2005; 5: 53–57.
[5] Ahmadi MH, Mirsalehian A, Bahador A. Prevalence of genital Chlamydia trachomatis in Iran: A systematic review and meta-analysis. Pathog Glob Health 2015; 109: 290– 299.
[6] Al-Sweih NA, Al-Fadli AH, Omu AE, Rotimi VO. Prevalence of Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium and Ureaplasma urealyticum infections and seminal quality in infertile and fertile men in Kuwait. J Androl 2012; 33: 1323–1329.
[7] Rybar R, Prinosilova P, Kopecka V, Hlavicova J, Veznik Z, Zajicova A, et al. The effect of bacterial contamination of semen on sperm chromatin integrity and standard semen parameters in men from infertile couples. Andrologia 2012; 44: 410–418.
[8] Gdoura R, Kchaou W, Ammar-Keskes L, Chakroun N, Sellemi A, Znazen A, et al. Assessment of Chlamydia trachomatis, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis and Mycoplasma genitalium in semen and first void urine specimens of asymptomatic male partners of infertile couples. J Androl 2008; 29: 198–206.
[9] Zhou YH, Ma HX, Shi XX, Liu Y. Ureaplasma spp. in male infertility and its relationship with semen quality and seminal plasma components. J Microbiol Immunol Infect 2018; 51: 778–783.
[10] Zeighami H, Peerayeh SN, Yazdi RS, Sorouri R. Prevalence of Ureaplasma urealyticum and Ureaplasma parvum in semen of infertile and healthy men. Int J STD AIDS 2009; 20: 387–390.
[11] Maleki S, Motamedi H, Moosavian SM, Shahbaziyan N. Frequency of Mycoplasma hominis and Ureaplasma urealyticum in females with urogenital infections and habitual abortion history in Ahvaz, Iran, using multiplex PCR. Jundishapur J Microbiol 2013; 6: 1–5.
[12] Ramazanzadeh R, Khodabandehloo M, Farhadifar F, Rouhi S, Ahmadi A, Menbari S, et al. A case-control study on the relationship between Mycoplasma genitalium infection in women with normal pregnancy and spontaneous abortion using polymerase chain reaction. Osong Public Health Res Perspect 2016; 7: 334–338.
[13] Huang C, Zhu HL, Xu KR, Wang SY, Fan LQ, Zhu WB. Mycoplasma and Ureaplasma infection and male infertility: A systematic review and meta-analysis. Andrology 2015; 3: 809–816.
[14] Bachir BG, Jarvi K. Infectious, inflammatory, and immunologic conditions resulting in male infertility. Urol Clin North Am 2014; 41: 67–81.
[15] Ahmadi MH, Mirsalehian A, Bahador A. Prevalence of urogenital mycoplasmas in Iran and their effects on fertility potential: A systematic review and meta-analysis. Iran J Public Health 2016; 45: 409–422.
[16] Ahmadi A, Ramazanzadeh R, Sayehmiri K, Sayehmiri F, Amirmozafari N. Association of Chlamydia trachomatis infections with preterm delivery: A systematic review and meta-analysis. BMC Pregnancy Childbirth 2018; 18: 240– 246.
[17] Janghorban R, Azarkish F. An overview on sexually transmitted infections in Iran. Int J Reprod Contracept Obstet Gynecol 2016; 5: 585–595.
[18] Moosavian M, Ghadiri A, Amirzadeh S, Rashno M, Afzali M, Ahmadi K. Investigating Chlamydia trachomatis and genital Mycoplasma prevalence and apoptosis markers in infertile and fertile couples. Jundishapur J Microbiol 2019; 12: e84954.
[19] Mohseni Moghadam N, Kheirkhah B, Mirshekari TR, Fasihi Harandi M, Tafsiri E. Isolation and molecular identification of Mycoplasma genitalium from the secretion of genital tract in infertile male and female. Iran J Reprod Med 2014; 12: 601–608.
[20] Safavifar F, Bandehpour M, Hosseiny SJ, Khorramizadeh MR, Shahverdi A, Kazemi B. Mycoplasma infection in pyospermic infertile and healthy fertile men. Novel Biomed 2015; 3: 25–29.
[21] Lee JSh, Kim KT, Lee HS, Yang KM, Seo JT, Choe JH. Concordance of Ureaplasma urealyticum and Mycoplasma hominis in infertile couples: Impact on semen parameters. Urology 2013; 81: 1219–1224.
[22] Günyeli I, Abike F, Dünder I, Aslan C, Tapısız ÖL, Temizkan O, et al. Chlamydia, Mycoplasma and Ureaplasma infections in infertile couples and effects of these infections on fertility. Arch Gynecol Obstet 2011; 283: 379– 385.
[23] Liu J, Wang Q, Ji X, Guo S, Dai Y, Zhang Z, et al. Prevalence of Ureaplasma urealyticum, Mycoplasma hominis, Chlamydia trachomatis infections, and semen quality in infertile and fertile men in China. Urology 2014; 83: 795–799.
[24] 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: 129–137.
[25] Plecko V, Zele-Starcevic L, Tripkovic V, Skerlev M, Ljubojevic S, Plesko S, et al. Unusually low prevalence of Mycoplasma genitalium in urine samples from infertile men and healthy controls: A prevalence study. BMJ Open 2014; 4: e005372.
[26] Ouzounova-Raykova V, Ouzounova I, Mitov I. Chlamydia trachomatis infection as a problem among male partners of infertile couples. Andrologia 2009; 41: 14–19.
[27] Mazzoli S, Cai T, Addonisio P, Bechi A, Mondaini N, Bartoletti R. Chlamydia trachomatis infection is related to poor semen quality in young prostatitis patients. Eur Urol 2010; 57: 708–714.
[28] Rose BI, Scott B. Sperm motility, morphology, hyperactivation, and ionophore-induced acrosome reactions after overnight incubation with mycoplasmas. Fertil Steril 1994; 61: 341–348.
[29] Deguchi T, Shimada Y, Horie K, Mizutani K, Seike K, Tsuchiya T, et al. Bacterial loads of Ureaplasma parvum contributes to the development of inflammatory responses in the male urethra. Int J STD AIDS 2015; 26: 1035–1039.