Document Type : Short Communication
Authors
1 Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece
2 Democritus University of Thrace, Laboratory of Physiology, Alexandroupolis, Greece
3 IASO General Hospital, Department of Microbiology, Larissa, Greece
4 4Democritus University of Thrace, Department of Microbiology, Alexandroupolis, Greece
5 Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece;4Democritus University of Thrace, Department of Microbiology, Alexandroupolis, Greece
Abstract
Keywords
Up to date, epidemiological studies have shown
that infertility affects approximately 10% of the
couples, whereas in 50% of this incident, a male
infertility associated factor is found (
Among the factors that might influence male
fertility, infections of the lower genital tract have
been the least investigated field. Effects of urogenital
tract pathogens on sperm concentration and
motility have still remained unclear and further
studies are needed to evaluate their influence on
male fertility. Particularly, the
From August 2013 until July 2015, a total of 172 men at the State of Thessaly, Greece, participated in the study. All participants enrolled in the study for semen analysis either inquired a microbiological evaluation (mainly due to clinical manifestations of genital tract infection or preventive screening), or were reported as being infertile after at least a 12-month unprotected sexual intercourse and failure to impregnate their wives. Informed consent was obtained from all participants and each individual filled in a questionnaire regarding demographic data, medical record and sexual history. Males with an underlying pathology (e.g. varicocele and hormone deficiency) to which oligoazoo- or asthenospermia could be attributed were excluded. Duplicate samples from individuals, even if surgical or medical treatment was applied, were not included in the study. Eventually, participants were divided into two groups according to TSN and irrespectively to reason of enrollment in order to study the prevalence of C-U-M in respect to sperm concentration and motility.
Semen samples of all participants were collected
into sterile nontoxic recipients by masturbation
after 3 to 5 days of sexual abstinence. All participants
were evaluated according to the guidelines
of World Health Organization (WHO) 2010 Semen
Analysis Reference Limits (
Mean and median values as well as SD were calculated and are given as mean ± SD or median. Unpaired t test, Fisher’s exact test, odds ratios (ORs), 95% confidence intervals (CI), as well as simple linear regression analysis (Pearson r) were performed using statistical software Statistical Package for the Social Sciences (SPSS, SPSS Inc., USA). Statistically significant difference was defined as the P<0.05.
Sixty-eight participants of the study had TSN≥39
millions (control group) and 104 were oligo- azoospermic
with TSN<39 millions (study group). In
the control group, mean age was 36.66 ± 5.96,
mean age of sexual initiation was 18.19 ± 3.15 and
median number of sexual partners was 6. In the
study group, mean age was 37.42 ± 5.50, mean age
of sexual initiation was 19.11 ± 3.69 and median
number of sexual partners was 6. Mean TSN of the
68 males of the control group was 258.59 ± 197.32
millions. Progressively motile spermatozoa, more
than 32%, were present in 46 participants (67.65%)
and totally motile spermatozoa, more than 40%,
were present in 63 (92.65%). C-U-M DNA was
present in 10 participants (14.71%). Particularly,
8 (11.76%) were positive for U. spp., two (2.94%)
for
Prevalence of the detected microorganisms among the participants of the study
Species | Participants with TSN | |
---|---|---|
≥39 millions of spermatozoa n (%) | <39 millions of spermatozoan (%) | |
C. trachomatis | 0 (0.00) | 1 (0.96) |
U. spp. | 8 (11.77) | 7 (6.73) |
M. hominis | 2 (2.94) | 2 (1.92) |
U. spp. | 2 (2.94) | 0 (0.00) |
M. hominis | ||
TSN; Total sperm number, C. trachomatis; Chlamydia trachomatis, U. spp.; Ureaplasma species, and M. hominis; Mycoplasma hominis.
Fisher’s exact test and calculation of ORs showed no higher probability of C-U-M carriage in men with low TSN (<39 million of spermatozoa) (P=0.17, OR=0.53 with 95% CI=0.21-1.29) or low sperm motility [progressive motility less or equal to 32% (P=0.15, OR=0.50 with 95% CI=0.20-1.23) and total motility less or equal to 40% (P=0.49, OR=0.66 with 95% CI=0.26-1.72), respectively]. There was no relation between C-U-M acquirement with age of sex initiation (cut off value more than and less or equal to 18) (P=1.00, OR=1.11 with 95% CI=0.45-2.74) or number of sex partners (cut off value more than and less or equal to 6) (P=0.82, OR=0.90 with 95% CI=0.37-2.20). Linear regression analysis showed negative correlation between age of sexual intercourse initiation with TSN (Pearson r=-0.918), sperm progressive motility (Pearson r=-0.666) and sperm total motility (Pearson r=-0.686). Also, positive correlations were shown for the number of sex partners with TSN (Pearson r=+0.493), sperm progressive motility (Pearson r=+0.125) and sperm total motility (Pearson r =+0.387).
In our study, nο correlation of C-U-M carriage to either oligo-azoospermia or asthenospermia was found. It should be noted that when the participants of the study were clustered not according to TSN but according to sperm concentration (semen conc.≥or <15 millions/ml, respectively), the statistical analysis showed no variances. Similar negative and positive correlation coefficients in regression analysis and P>0.05 in chi-square tests were obstructed (statistical analysis and statistical data not shown). Our findings are in accordance with Al-Sweih et al. (
Under the scope of a possible correlation of sexual behavior to C-U-M acquirement that might influence semen quality, we found that semen parameters were correlated negatively to the age of sexual intercourse initiation and positively to the number of sex partners. In other words, the earlier a man initiated his sexual life and the more sexual partners he had, the better tested semen parameters he appeared to have. Moreover, the early age of sexual intercourse initiation or the high number of sexual partners was not statistical significantly and correlated to C-U-M acquirement.
In conclusion, TSN and sperm motility seem not to be influenced by the presence of C-U-M genera in a sample of Greek men undergoing semen evaluation. Although prevalence of C-U-M in our sample was low [as was expected due to a lately published large-scale study from Central Greece (