[Genital infection and infertility]

Prevalence of Certain Urogenital Bacterial Mollicutes in Patients Suffering from Infertility

Introduction

Mollicutes urogenital tract infections are considered a possible cause of infertility worldwide. Genital Mollicutes infections are difficult and impractical to diagnose by culturing or serology. Mollicutes included in this study were Mycoplasma hominis, Ureaplasma urealyticum, and Mycoplasma genitalium. This cross-sectional study aimed to determine the prevalence of M. hominis, U. urealyticum, and M. genitalium genital infections among infertile males and females patients.

Methods

This study included 103 patients who visited Al-Shunar Clinic in Nablus city in Palestine and diagnosed with infertility during January 2018 to October 2018. The semen, urine, and/or vaginal swab specimens collected from patients were examined by PCR for detection of M. hominis, U. urealyticum, and M. genitalium.

Results

A total of 57 semen, 37 urine, and 16 vaginal swab specimens were collected. Out of the 110 examined specimens, 35 (31.8%) were PCR positive for at least one Mollicutes, which were 16 (14.6%) M. hominis, 11 (10%) U. urealyticum, and 8 (7.3%) M. genitalium. Significant association were found between infections of M. hominis and U. urealyticum (P=0.044) and between M. hominis and M. genitalium (P=0.005) infections. M. hominis infection was found in significantly (P=0.048) higher percentage in males (20.6%) in comparison with females (5.7%). On the other hand, M. genitalium infection rate in females (8.6%) was slightly higher than males (7.4%). M. hominis was more prevalent in all age groups except for patient's age group 40–50 years old, where M. genitalium was more prevalent. M. hominis was also more prevalent in all occupation types and among all smokers.

Conclusion

Urogenital infections caused by M. hominis, M. genitalium, and U. urealyticum could be a possible cause of infertility among patients with different age groups, genders, and occupations. Thus, more attention by infertility centers and physicians is required in adopting molecular methods for diagnosis of infections by these microorganisms.

Capabilities of combined peptide drugs in the correction of male infertility (literature review)

Acute and chronic urogenital infections are associated with male infertility. Besides "traditional" sexually transmitted infections, there is a significant increase in inflammatory diseases of reproductive system caused by opportunistic pathogens. Studies show that sperm fertility is influenced by direct exposure to sexually transmitted infections, as well as dysfunction of the blood-testicular barrier, leading to autoimmune infertility. In a number of clinical trials, Prostatilen AC was shown to have benefitial effects on the ejaculate.

Relationships between female infertility and female genital infections and pelvic inflammatory disease: a population-based nested controlled study

OBJECTIVES

Our purpose was to examine the associations of female genital infections and certain comorbidities with infertility.

METHODS

The Taiwan National Health Research Database was searched for women with a new diagnosis of infertility between 2000 and 2013. Women without a diagnosis of infertility served as a control group and were matched with the infertility cases by age (±3 years) and index year. They were divided into two groups: ≤40 years old and >40 years old. Univariate and multivariate conditional logistic regression models were employed to identify the risk factors associated with infertility.

RESULTS

A total of 18,276 women with a new diagnosis of infertility and 73,104 matched controls (mean cohort age, 31±6.2 years) were included. According to the adjusted multivariate analysis, pelvic inflammatory disease involving the ovary, fallopian tube, pelvic cellular tissue, peritoneum (odds ratio (OR)=4.823), and uterus (OR=3.050) and cervical, vaginal, and vulvar inflammation (OR=7.788) were associated with an increased risk of infertility in women aged ≤40 years. In women aged >40 years, pelvic inflammatory disease of the ovary, fallopian tube, pelvic cellular tissue, and peritoneum (OR=6.028) and cervical, vaginal, and vulvar inflammation (OR=6.648) were associated with infertility. Obesity, lipid metabolism disorders, dysthyroidism, abortion (spontaneous or induced), bacterial vaginosis, endometritis, and tubo-ovarian abscess were associated with an increased risk of infertility according to the univariate analysis but not the multivariate analysis.

CONCLUSIONS

Female genital tract infections, but not the comorbidities studied here, are associated with an increased risk of infertility.

Effects of infections with five sexually transmitted pathogens on sperm quality

Objective

This study investigated the prevalence of infections with human papillomavirus, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, and Mycoplasma genitalium in the semen of Korean infertile couples and their associations with sperm quality.

Methods

Semen specimens were collected from 400 men who underwent a fertility evaluation. Infection with above five pathogens was assessed in each specimen. Sperm quality was compared in the pathogen-infected group and the non-infected group.

Results

The infection rates of human papillomavirus, C. trachomatis, U. urealyticum, M. hominis, and M. genitalium in the study subjects were 1.57%, 0.79%, 16.80%, 4.46%, and 1.31%, respectively. The rate of morphological normality in the U. urealyticum-infected group was significantly lower than in those not infected with U. urealyticum. In a subgroup analysis of normozoospermic samples, the semen volume and the total sperm count in the pathogen-infected group were significantly lower than in the non-infected group.

Conclusion

Our results suggest that infection with U. urealyticum alone and any of the five sexually transmitted infections are likely to affect sperm morphology and semen volume, respectively.

Prevalence of Ureaplasma urealyticum and Mycoplasma hominis in High Vaginal Swab Samples of Infertile Females

Background:

Mycoplasma hominis and Ureaplasma urealyticum are important causative agents of vaginitis, cervicitis, postpartum sepsis, reproductive infections and infertility in both males and females.

Objectives:

According to the uncertain prevalence of U. urealyticum and M. hominis in Iranian infertile females, the present study was carried out to determine the prevalence of U. urealyticum and M. hominis in high vaginal swab samples of fertile and infertile females.

Patients and Methods:

A total of 350 high vaginal swab specimens were taken from fertile and infertile females. Samples were cultured and those that were positive for bacteria were subjected to the polymerase chain reaction (PCR) for further confirmation.

Results:

Of the 350 collected samples, eleven were positive for M. hominis (3.14%), fifteen were positive for U. urealyticum (4.28%) and five were positive for both of them (1.42%). Prevalence of U. urealyticum and M. hominis in the high vaginal parts of infertile females was higher than fertile females (P < 0.05). The results of traditional method were also confirmed, using the PCR amplification of urease gene of U. urealyticum and 16SrRNA gene of the M. hominis.Ureaplasma urealyticum and M. hominis had a higher prevalence in the high vaginal samples collected during the summer season.

Conclusions:

Considerable prevalence of M. hominis and U. urealyticum in the high vaginal swab samples of infertile females compared to the low prevalence in fertile females may suggest that these two pathogens can be cause infertility. Application of the PCR method is recommended for rapid and sensitive detection of M. hominis and U. urealyticum in high vaginal swab samples.

Distribution of Chlamydia trachomatis serotypes in clinical urogenital samples from north-eastern Croatia

The purpose of this study was to determine prevalence of Chlamydia trachomatis (Ct) urogenital infection and its serotype distribution from clinical samples in north-eastern Croatia. During a 3-year period, 2,379 urogenital samples were analyzed by real-time polymerase chain reaction (A group), while 4,846 genital swabs were analyzed by direct fluorescent antibody test (B group). 132 Ct positive specimens were genotyped by omp1 gene sequencing. The prevalence rate of Ct was 3.2 % in A and 1 % in B group. The most prevalent chlamydial genotype was E (44 %), followed by F (33 %), K (11.5 %), G (8 %), J/UW (5.3 %), D-IC (4.4 %), D-B120 (1.8 %), and B/IU, J/IU, Ia/IU (0.9 % each) serotypes. Single-nucleotide polymorphisms (SNPs) of omp1 gene were detected in E, K, and G serotypes. Some of these SNPs (C/T at position 272 and G/A at position 813 in E strain; C/T at position 884 in D strain) might represent novel omp1 variants.

Chlamydia, Mycoplasma and Ureaplasma infections in infertile couples and effects of these infections on fertility

OBJECTIVE

In our study, we aimed to determine the prevalence of Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum infections among infertile couples and effects of these infections on infertility.

MATERIALS AND METHODS

Prevalence of Chlamydia, Mycoplasma, Ureaplasma antibodies and Chlamydia IgM antibodies and its effect on these agents' sperm parameters, namely, morphology, density, and motility were investigated among a total of 212 patients including fertile and infertile couples. Chlamydia, Mycoplasma, Ureaplasma antigens were evaluated using ELISA in the cervical and urethral samples. Chlamydia IgM antibody was measured using micro-ELISA in blood samples.

RESULTS

No difference was detected among the fertile and infertile groups in the serological investigation of urethral and cervical samples with respect to the prevalence of Chlamydia, Mycoplasma, Ureaplasma antigens and Chlamydia IgM antibody and sperm parameters (p > 0.05).

DISCUSSION

There is no significant difference between fertile and infertile couples in terms of the prevalence of the above mentioned infections. Accordingly, during the infertility assessment, infertile couples should not be routinely screened for these infective agents without any clinically sound evidence.

[Gonococcal infection related hospital admissions in Madrid: 1997-2006]

OBJECTIVE

Gonorrhoea is one of the most frequent sexually transmitted diseases in the world. It is a serious problem due to its morbidity, complications and associated sequelae. This study aims to estimate the frequency of hospitalisations due to gonococcal infection in Madrid between 1997 and 2006.

METHOD

A retrospective epidemiological study was performed using data from the National Epidemiological Surveillance System for hospital data (Minimum Basic Data Set, [MBDS]). All hospitalisations related to gonococcal infection in Madrid were analysed. Information on hospitalisation rates, mortality, fatality and stay were obtained and gathered by year, sex and age.

RESULTS

During this study period, 113 hospitalisations related to gonococcal infection were recorded (Spanish Version of the International Classification of Diseases, 9th Revision, Clinical Modification: ICD-9-CM codes 098.0 and 098.89, any diagnostic position) representing a hospitalisation rate of 0.21 per 100,000, mortality rate of 0.02 per 100,000 people and case-fatality rate of 9.73%. An increased rate of hospitalisation in children up to 4 years and adults older than 65 years was observed.

CONCLUSION

The hospitalisation rate in patients with gonococcal infection has decreased in recent years, but it is important to continue with existing public health and control policies and create new ones to reduce these figures.

The prevalence of ureaplasma urealyticum, mycoplasma hominis, chlamydia trachomatis and neisseria gonorrhoeae infections, and the rubella status of patients undergoing an initial infertility evaluation

PURPOSE

To determine the prevalence of positive test for Ureaplasma urealyticum (UU), Mycoplasma hominis (MH), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) infections, and their corresponding Rubella status when undergoing workup for infertility.

METHODS

Retrospective chart review to determine infection status for UU, MH, CT, and NG as determined by cervical swab, as well as the serum Rubella antibody titer.

RESULTS

A total of 46 patients of the patients reviewed were positive for UU (20.1%), three patients were positive for MH (1.3%), five patients were positive for CT (2.2%) and one patient was positive for NG (0.4%). Rubella immunity was confirmed in 90.3% of patients.

CONCLUSION

Approximately one quarter of women presenting to an infertility clinic seeking to conceive were found to have a positive test for UU, MH, CT or NG infection. Additionally, almost 10% of the patients were Rubella non-immune at the time of presentation for infertility evaluation.