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Arasu Y, Bryan E, Russell FA, Huettner N, Carey AJ, Boyd BJ, Beagley KW, Dargaville TR. Enhanced clearance of C. muridarum infection using azithromycin-loaded liposomes. Int J Pharm 2024; 650:123709. [PMID: 38101758 DOI: 10.1016/j.ijpharm.2023.123709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023]
Abstract
Chlamydia trachomatis is an intracellular bacterium which infects around 129 million people annually. Despite similar infection rates between sexes, most research investigating the effects of chlamydial infection on fertility has focused on females. There is now emerging evidence of a potential link between Chlamydia and impaired male fertility. The only treatments for chlamydial infection are antibiotics, with azithromycin (AZI) being one of the commonly used drugs. However, recent studies have suggested that optimizing the treatment regime is necessary, as higher concentrations of AZI may be required to effectively clear the infection in certain cell types, particularly testicular macrophages. To address this challenge, we have prepared liposomes consisting of 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) and D-α-tocopheryl polyethylene glycol 1000 succinate (TPGS) loaded with AZI for clearing Chlamydia. These liposomes exhibited stability over time and were readily taken up by both macrophages and epithelial cells. Moreover, they demonstrated significant enhancement of chlamydial clearance in both cell types. In a mouse model, the drug-loaded liposomes cleared Chlamydia within the penile urethra more efficiently than the same dose of unencapsulated drug. Furthermore, the liposome-drug treatment showed significant protective effects on sperm motility and morphology, suggesting potential benefits in reducing sperm damage caused by the infection.
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Affiliation(s)
- Yanushia Arasu
- School of Chemistry and Physics and Centre for Materials Science, Faculty of Science, Queensland University of Technology, Brisbane, Australia; School of Biomedical Sciences and Centre for Immunology and Infection Control, Queensland University of Technology, Brisbane, Australia
| | - Emily Bryan
- School of Biomedical Sciences and Centre for Immunology and Infection Control, Queensland University of Technology, Brisbane, Australia
| | - Freya A Russell
- School of Biomedical Sciences and Centre for Immunology and Infection Control, Queensland University of Technology, Brisbane, Australia
| | - Nick Huettner
- School of Chemistry and Physics and Centre for Materials Science, Faculty of Science, Queensland University of Technology, Brisbane, Australia
| | - Alison J Carey
- School of Biomedical Sciences and Centre for Immunology and Infection Control, Queensland University of Technology, Brisbane, Australia
| | - Ben J Boyd
- Drug Delivery, Disposition & Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Clayton, Australia; Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kenneth W Beagley
- School of Biomedical Sciences and Centre for Immunology and Infection Control, Queensland University of Technology, Brisbane, Australia
| | - Tim R Dargaville
- School of Chemistry and Physics and Centre for Materials Science, Faculty of Science, Queensland University of Technology, Brisbane, Australia.
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2
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Saint F, Huyghe E, Methorst C, Priam A, Seizilles de Mazancourt E, Bruyère F, Faix A. [Infections and male infertility]. Prog Urol 2023; 33:636-652. [PMID: 38012909 DOI: 10.1016/j.purol.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The role of urogenital infections in male infertility has long been the subject of debate. METHODS A bibliographic search limited to English-language literature on human subjects published before 5/2023 resulted in the selection of 189 articles. RESULTS Male infertility is often of multifactorial aetiology, and to optimise the prognosis it is important to manage all the factors that can be corrected, including infectious causes, which represent one of the most frequent aetiologies. The infectious agents involved in urogenital infections are most often bacterial or viral, and more rarely parasitic. They can infect the seminal tract, male accessory glands and/or testicles, and usually result in inflammation and increased oxidative stress. These infections reduce male fertility, in particular by altering spermogram parameters and increasing sperm DNA fragmentation. For these reasons, the search for a urogenital infection should be systematic, involving a careful history and clinical examination, ultrasound and systematic bacteriological tests guided by clinical findings. Aetiological treatment may be proposed depending on the picture and the germ involved. CONCLUSION This review should help the urologist to establish an accurate diagnosis of the form and extent of the infection, and enable him to define an appropriate therapeutic strategy, tailored to the patient, in order to obtain the best chances of improving male fertility.
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Affiliation(s)
- F Saint
- Service d'urologie-transplantation, CHU Amiens Picardie, Amiens, France; Laboratoire EPROAD EA 4669, université Picardie Jules-Verne, Amiens, France
| | - E Huyghe
- Département d'urologie, hôpital de Rangueil, CHU de Toulouse, Toulouse, France; Service de médecine de la reproduction, hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France; UMR DEFE, Inserm 1203, université de Toulouse, université de Montpellier, Montpellier, France.
| | - C Methorst
- Service de médecine de la reproduction, hôpital des 4 villes, Saint-Cloud, France
| | - A Priam
- Service d'urologie-transplantation, CHU Amiens Picardie, Amiens, France
| | | | - F Bruyère
- Urologie, CHRU de Tours, Tours, France
| | - A Faix
- Clinique Saint-Roch, 560, avenue du Colonel-Pavelet-dit-Villars, 34000 Montpellier, France
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3
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Detection of Chlamydia trachomatis inside spermatozoa using flow cytometry: Effects of antibiotic treatment (before and after) on sperm count parameters. J Microbiol Methods 2022; 203:106604. [PMID: 36330892 DOI: 10.1016/j.mimet.2022.106604] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 11/07/2022]
Abstract
There is increasing evidence that Chlamydia trachomatis (CT) infection can directly affect male fertility. However, only few have investigated the effects of CT on semen parameters, and mostly with inconclusive results. The main aims of this study were to identify CT inside spermatozoa, and the possible pre and post antibiotic treatment effects on the overall semen parameters. We developed a flow cytometric method for the detection of CT inside spermatozoa (SPI™). Briefly, sperm cells were fixed, membrane permeabilized and DNA was loosened using DNAse. Sperm cells were incubated with a primary monoclonal antibody against CT and with a secondary fluorescent antibody (vs primary), and analysed using a flow cytometer. Of 2415 infertile individuals, 48.61% were found positive for CT. 170 CT+ samples were included in the CT antibiotic treatment study. 78.82% (134/170) of the CT+ showed a significant reduction in the percentage of the iCT infected spermatozoa after the antibiotic treatment; 59.70% (80/134) decreased to non-detectable levels. Spermcount data were also recorded. Spermatozoa morphology (normal and teratozoospermia index, TZI) and motility (fast progressive and non-progressive spermatozoa) were statistically significant altered in CT+ pre-treatment vs control group. CT antibiotic treatment showed statistically significant effects on normal spermatozoa morphology, mid-piece and tail defects, and TZI. The study demonstrated that semen flow cytometric analysis of semen could be a valuable tool for faster and accurate identification of individuals with asymptomatic CT infection. It also identified a positive effect of antibiotic therapy on semen parameters, that could help males with infertility.
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4
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Tvrdá E, Ďuračka M, Benko F, Lukáč N. Bacteriospermia - A formidable player in male subfertility. Open Life Sci 2022; 17:1001-1029. [PMID: 36060647 PMCID: PMC9386612 DOI: 10.1515/biol-2022-0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/29/2022] [Accepted: 05/18/2022] [Indexed: 11/24/2022] Open
Abstract
Bacterial colonization of male reproductive tissues, cells, and fluids, and the subsequent impact of bacteria on the sperm architecture, activity, and fertilizing potential, has recently gained increased attention from the medical and scientific community. Current evidence strongly emphasizes the fact that the presence of bacteria in semen may have dire consequences on the resulting male fertility. Nevertheless, the molecular basis underlying bacteriospermia-associated suboptimal semen quality is sophisticated, multifactorial, and still needs further understanding. Bacterial adhesion and subsequent sperm agglutination and immobilization represent the most direct pathway of sperm-bacterial interactions. Furthermore, the release of bacterial toxins and leukocytic infiltration, associated with a massive outburst of reactive oxygen species, have been repeatedly associated with sperm dysfunction in bacteria-infested semen. This review serves as a summary of the present knowledge on bacteriospermia-associated male subfertility. Furthermore, we strived to outline the currently available methods for assessing bacterial profiles in semen and to outline the most promising strategies for the prevention and/or management of bacteriospermia in practice.
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Affiliation(s)
- Eva Tvrdá
- Department of Animal Physiology, Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, Nitra-Chrenová, 949 76, Slovakia
| | - Michal Ďuračka
- Department of Animal Physiology, Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, Nitra-Chrenová, 949 76, Slovakia
| | - Filip Benko
- Department of Animal Physiology, Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, Nitra-Chrenová, 949 76, Slovakia
| | - Norbert Lukáč
- Department of Animal Physiology, Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, Nitra-Chrenová, 949 76, Slovakia
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5
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Izadi M, Dehghan Marvast L, Rezvani ME, Zohrabi M, Aliabadi A, Mousavi SA, Aflatoonian B. Mesenchymal Stem-Cell Derived Exosome Therapy as a Potential Future Approach for Treatment of Male Infertility Caused by Chlamydia Infection. Front Microbiol 2022; 12:785622. [PMID: 35095800 PMCID: PMC8792933 DOI: 10.3389/fmicb.2021.785622] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/08/2021] [Indexed: 01/08/2023] Open
Abstract
Some microbial sexually transmitted infections (STIs) have adverse effects on the reproductive tract, sperm function, and male fertility. Given that STIs are often asymptomatic and cause major complications such as urogenital inflammation, fibrosis, and scarring, optimal treatments should be performed to prevent the noxious effect of STIs on male fertility. Among STIs, Chlamydia trachomatis is the most common asymptomatic preventable bacterial STI. C. trachomatis can affect both sperm and the male reproductive tract. Recently, mesenchymal stem cells (MSCs) derived exosomes have been considered as a new therapeutic medicine due to their immunomodulatory, anti-inflammatory, anti-oxidant, and regenerative effects without consequences through the stem cell transplantation based therapies. Inflammation of the genital tract and sperm dysfunction are the consequences of the microbial infections, especially Chlamydia trachomatis. Exosome therapy as a noninvasive approach has shown promising results on the ability to regenerate the damaged sperm and treating asthenozoospermia. Recent experimental methods may be helpful in the novel treatments of male infertility. Thus, it is demonstrated that exosomes play an important role in preventing the consequences of infection, and thereby preventing inflammation, reducing cell damage, inhibiting fibrogenesis, and reducing scar formation. This review aimed to overview the studies about the potential therapeutic roles of MSCs-derived exosomes on sperm abnormalities and male infertility caused by STIs.
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Affiliation(s)
- Mahin Izadi
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Reproductive Biology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Laleh Dehghan Marvast
- Andrology Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Ebrahim Rezvani
- Department of Physiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Marzieh Zohrabi
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Reproductive Biology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Aliabadi
- Department of Physiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Alireza Mousavi
- Infectious Disease Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Behrouz Aflatoonian
- Department of Reproductive Biology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Stem Cell Biology Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Advanced Medical Sciences and Technologies, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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6
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Bryan ER, Redgrove KA, Mooney AR, Mihalas BP, Sutherland JM, Carey AJ, Armitage CW, Trim LK, Kollipara A, Mulvey PBM, Palframan E, Trollope G, Bogoevski K, McLachlan R, McLaughlin EA, Beagley KW. Chronic testicular Chlamydia muridarum infection impairs mouse fertility and offspring development†. Biol Reprod 2021; 102:888-901. [PMID: 31965142 PMCID: PMC7124966 DOI: 10.1093/biolre/ioz229] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 11/28/2019] [Accepted: 01/12/2020] [Indexed: 12/26/2022] Open
Abstract
With approximately 131 million new genital tract infections occurring each year, Chlamydia is the most common sexually transmitted bacterial pathogen worldwide. Male and female infections occur at similar rates and both cause serious pathological sequelae. Despite this, the impact of chlamydial infection on male fertility has long been debated, and the effects of paternal chlamydial infection on offspring development are unknown. Using a male mouse chronic infection model, we show that chlamydial infection persists in the testes, adversely affecting the testicular environment. Infection increased leukocyte infiltration, disrupted the blood:testis barrier and reduced spermiogenic cell numbers and seminiferous tubule volume. Sperm from infected mice had decreased motility, increased abnormal morphology, decreased zona-binding capacity, and increased DNA damage. Serum anti-sperm antibodies were also increased. When both acutely and chronically infected male mice were bred with healthy female mice, 16.7% of pups displayed developmental abnormalities. Female offspring of chronically infected sires had smaller reproductive tracts than offspring of noninfected sires. The male pups of infected sires displayed delayed testicular development, with abnormalities in sperm vitality, motility, and sperm-oocyte binding evident at sexual maturity. These data suggest that chronic testicular Chlamydia infection can contribute to male infertility, which may have an intergenerational impact on sperm quality.
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Affiliation(s)
- Emily R Bryan
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, Herston, Queensland, Australia
| | - Kate A Redgrove
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Alison R Mooney
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, Herston, Queensland, Australia
| | - Bettina P Mihalas
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Jessie M Sutherland
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Alison J Carey
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, Herston, Queensland, Australia
| | - Charles W Armitage
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, Herston, Queensland, Australia.,Peter Goher Department of Immunobiology, King's College London, London, United Kingdom
| | - Logan K Trim
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, Herston, Queensland, Australia
| | - Avinash Kollipara
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, Herston, Queensland, Australia
| | - Peter B M Mulvey
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, Herston, Queensland, Australia
| | - Ella Palframan
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, Herston, Queensland, Australia
| | - Gemma Trollope
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, Herston, Queensland, Australia
| | - Kristofor Bogoevski
- Scientific Services, Histology Services, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Robert McLachlan
- Department of Obstetrics and Gynaecology, Hudson Institute of Medical Research, Monash Medical Centre, Monash University, Clayton, Victoria, Australia
| | - Eileen A McLaughlin
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia.,School of Science, Western Sydney University, Richmond, New South Wales, Australia.,School of Life Sciences, The University of Auckland, Auckland, New Zealand
| | - Kenneth W Beagley
- School of Biomedical Sciences and Institute of Health & Biomedical Innovation, Queensland University of Technology, Herston, Queensland, Australia
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7
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Hulse L, Beagley K, Larkin R, Nicolson V, Gosálvez J, Johnston S. The effect of Chlamydia infection on koala (Phascolarctos cinereus) semen quality. Theriogenology 2021; 167:99-110. [PMID: 33813053 DOI: 10.1016/j.theriogenology.2021.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 01/06/2023]
Abstract
Although it is well established that chlamydial disease renders female koalas infertile, there has been limited research on its effects on male koala fertility, specifically sperm quality. This study determined whether chlamydial infection adversely affects semen quality of naturally infected koalas and spermatozoa recovered from Chlamydia negative koalas co-incubated in vitro with C. pecorum elementary bodies (EBs). Semen from 102 south-east Queensland sexually mature wild koalas exhibiting varying degrees of chlamydiosis and clinical signs of disease were assessed for semen quality and compared to 11 clinically healthy, Chlamydia-free captive male koalas. For in vitro studies, semen samples were collected from 6 Chlamydia-free captive koalas, and co-incubated over 24 h with high and low concentrations of C. pecorum EBs and sperm quality assessed. Wild koalas displaying severe signs of clinical disease with C. pecorum present in the semen had significantly greater sperm DNA damage (P = 0.0267). The total % of morphologically abnormal spermatozoa was highest in wild koalas that had severe signs of clinical disease but whose semen was negative for C. pecorum (P = 0.0328). This apparent contradiction is possibly associated with wild males having resolved the infection but still possessing underlining reproductive pathology. A higher incidence of loose head spermatozoa occurred in semen of wild koalas not infected with C. pecorum compared to those that were C. pecorum infected (P = 0.026). In vitro incubation of semen with C. pecorum significantly decreased sperm motility and viability over 24 h.
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Affiliation(s)
- Lyndal Hulse
- School of Agriculture and Food Sciences, University of Queensland, Gatton, Queensland, 4343, Australia.
| | - Kenneth Beagley
- Centre for Immunology and Infection Control and School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, 300 Herston Road, Herston, Queensland, 4006, Australia
| | - Rebecca Larkin
- Moggill Koala Rehabilitation Centre (previously Known As Moggill Koala Hospital), 55 Priors Pocket Road, Moggill, Queensland, 4070, Australia
| | | | - Jaime Gosálvez
- Genetics Unit, Facultad de Biología, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | - Stephen Johnston
- School of Agriculture and Food Sciences, University of Queensland, Gatton, Queensland, 4343, Australia
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8
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Bryan ER, Barrero RA, Cheung E, Tickner JAD, Trim LK, Richard D, McLaughlin EA, Beagley KW, Carey AJ. DNA damage contributes to transcriptional and immunological dysregulation of testicular cells during Chlamydia infection. Am J Reprod Immunol 2021; 86:e13400. [PMID: 33565167 DOI: 10.1111/aji.13400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 09/23/2020] [Accepted: 02/06/2021] [Indexed: 01/17/2023] Open
Abstract
Chlamydia is the most commonly reported sexually transmitted bacterial infection, with 127 million notifications worldwide each year. Both males and females are susceptible to the pathological impacts on fertility that Chlamydia infections can induce. However, male chlamydial infections, particularly within the upper reproductive tract, including the testis, are not well characterized. In this study, using mouse testicular cell lines, we examined the impact of infection on testicular cell lineage transcriptomes and potential mechanisms for this impact. The somatic cell lineages exhibited significantly fragmented genomes during infection. Likely resulting from this, each of the Leydig, Sertoli and germ cell lineages experienced extensive transcriptional dysregulation, leading to significant changes in cellular biological pathways, including interferon and germ-Sertoli cell signalling. The cell lineages, as well as isolated spermatozoa from infected mice, also contained globally hypomethylated DNA. Cumulatively, the DNA damage and epigenetic-mediated transcriptional dysregulation observed within testicular cells during chlamydial infection could result in the production of spermatozoa with abnormal epigenomes, resulting in previously observed subfertility in infected animals and congenital defects in their offspring.
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Affiliation(s)
- Emily R Bryan
- School of Biomedical Sciences and Centre for Immunology and Infection Control, Queensland University of Technology, Herston, QLD, Australia
| | - Roberto A Barrero
- eResearch Office and Division of Research & Innovation, Queensland University of Technology, Brisbane City, QLD, Australia
| | - Eddie Cheung
- School of Biomedical Sciences and Centre for Immunology and Infection Control, Queensland University of Technology, Herston, QLD, Australia
| | - Jacob A D Tickner
- School of Biomedical Sciences and Genomics and Precision Health Centre, Queensland University of Technology, Woolloongabba, QLD, Australia
| | - Logan K Trim
- School of Biomedical Sciences and Centre for Immunology and Infection Control, Queensland University of Technology, Herston, QLD, Australia
| | - Derek Richard
- School of Biomedical Sciences and Genomics and Precision Health Centre, Queensland University of Technology, Woolloongabba, QLD, Australia
| | - Eileen A McLaughlin
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, Callaghan, NSW, Australia.,School of Science, Western Sydney University, Penrith, NSW, Australia
| | - Kenneth W Beagley
- School of Biomedical Sciences and Centre for Immunology and Infection Control, Queensland University of Technology, Herston, QLD, Australia
| | - Alison J Carey
- School of Biomedical Sciences and Centre for Immunology and Infection Control, Queensland University of Technology, Herston, QLD, Australia
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9
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Farsimadan M, Motamedifar M. Bacterial infection of the male reproductive system causing infertility. J Reprod Immunol 2020; 142:103183. [PMID: 32853846 DOI: 10.1016/j.jri.2020.103183] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 06/03/2020] [Accepted: 07/29/2020] [Indexed: 12/13/2022]
Abstract
Bacterial infections play a disruptive and hidden role in male reproductive failure. Different kinds of bacteria are often able to interfere with reproductive function in both sexes and lead to infertility. In this study, to further evaluate the role of bacterial infections in male reproduction we provided an extensive overview of so far researches investigating the effects of bacterial infections on male fertility. We searched Medline, PubMed, Scopus and Google scholar databases to identify the potentially relevant studies on bacterial infections and their implications in male infertility. All the bacteria included in this article have negative effects on the male reproductive function; however, there is ample evidence to blame bacteria such as Escherichia coli, Chlamydia trachomatis, Ureaplasma, Mycoplasma and Staphylococcus aureus for reduced fertility and deterioration of sperm parameters. More studies are needed to clarify the molecular mechanisms by which different bacteria exert their detrimental effects on male reproductive system. Getting more insight into probable mechanisms, would significantly facilitate the production of new, advanced, and effective remedies in the future. In view of all evidence, we strongly suggest increasing awareness among people and considering screening programs for patients seeking fertility both to avoid transmission and to improve fertility outcomes among them.
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Affiliation(s)
- Marziye Farsimadan
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran.
| | - Mohammad Motamedifar
- Department of Bacteriology and Virology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
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10
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Bryan ER, Kim J, Beagley KW, Carey AJ. Testicular inflammation and infertility: Could chlamydial infections be contributing? Am J Reprod Immunol 2020; 84:e13286. [DOI: 10.1111/aji.13286] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
- Emily R. Bryan
- School of Biomedical Sciences Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Qld Australia
| | - Jay Kim
- School of Biomedical Sciences Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Qld Australia
| | - Kenneth W. Beagley
- School of Biomedical Sciences Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Qld Australia
| | - Alison J. Carey
- School of Biomedical Sciences Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Qld Australia
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11
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Oghbaei H, Rastgar Rezaei Y, Nikanfar S, Zarezadeh R, Sadegi M, Latifi Z, Nouri M, Fattahi A, Ahmadi Y, Bleisinger N. Effects of bacteria on male fertility: Spermatogenesis and sperm function. Life Sci 2020; 256:117891. [PMID: 32504760 DOI: 10.1016/j.lfs.2020.117891] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/24/2020] [Accepted: 05/30/2020] [Indexed: 11/24/2022]
Abstract
Bacterial infection can negatively affect different parts of the male genital tract and subsequently cause impaired spermatogenesis and male fertility. However, most of the previous studies have focused on the infected organs of the male genital tract and there are not many studies that investigated the direct effect of bacteria on sperm and their mechanism of action. Interestingly, bacteria can induce different damages on sperm cells such as DNA fragmentation, cell membrane peroxidation, and acrosome impairment. Such negative effects can be mediated by bacteria-secreted toxins and metabolites or by direct attachment of bacteria on the sperm cells and subsequent activation of signaling pathways related to oxidative stress, apoptosis, and inflammation. These bacteria-induced changes can impair semen parameters and subsequently cause infertility. Given the significant destructive effect of some bacteria on sperm function and male fertility, in this study, we reviewed the impact of male urogenital bacteria on spermatogenesis and sperm functions as well as the underlying mechanisms by which the bacteria can damage sperm.
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Affiliation(s)
- Hajar Oghbaei
- Department of Physiology, Tabriz University of Medical Sciences, Tabriz, Iran; Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yeganeh Rastgar Rezaei
- Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saba Nikanfar
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Zarezadeh
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammadreza Sadegi
- Department of Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Latifi
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Nouri
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Fattahi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany.
| | - Yadollah Ahmadi
- Department of Urology, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Nathalie Bleisinger
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
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Abstract
BACKGROUND Sexually transmitted infections (STI) are common worldwide and can cause impairment of fertility. In women pelvic inflammatory disease with subsequent tubal sterility is well-documented but the influence of STI on male fertility is still controversely discussed OBJECTIVE: The effects of various bacterial and viral STI on male fertility are discussed. MATERIAL AND METHODS An evaluation of the international literature up to 30 April 2018 was carried out including studies on larger collectives from the Asiatic region. RESULTS There is still an inconsistent picture of the influence of various bacterial and viral STI on male fertility. Direct or indirect evidence of the impact of a pathogen alone on the quality of ejaculates could not be clearly demonstrated; however, there are indications of a negative effect by Mycoplasma and Ureaplasma species in large Asiatic collectives. The transmission of viral pathogens, such as human papillomavirus (HPV), herpes simplex virus (HSV) and hepatitis B virus (HBV) possible impairs the success of assisted reproductive techniques. In contrast, manifest inflammatory processes of the male genital tract caused by STI (in particular Chlamydia and gonococci) or human immunodeficiency virus (HIV) infections often result in impairment of sperm qualtity. CONCLUSION In cases of male fertility disorders a microbiological clarification is recommended. Further studies on the effect of STI on male fertility in larger collectives are necessary, particularly for Caucasian populations. The utilization of existing preventive measures, such as screening for Chlamydia in young women and HPV vaccination also for young males, should be intensively promoted.
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Affiliation(s)
- P Spornraft-Ragaller
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - D Varwig-Janßen
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
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Eckert T, Goericke-Pesch S, Heydel C, Bergmann M, Kauffold J, Failing K, Wehrend A. Interaction of different Chlamydiae species with bovine spermatozoa. BMC Microbiol 2019; 19:23. [PMID: 30683062 PMCID: PMC6347757 DOI: 10.1186/s12866-019-1392-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 01/10/2019] [Indexed: 01/15/2023] Open
Abstract
Background Interaction of spermatozoa and Chlamydiae spp. might contribute to reduced fertility in cattle. To proof this hypothesis, bovine semen was incubated with viable or heat inactivated Chlamydia (C.) abortus or psittaci (Multiplicity of infection = 1) and sperm motility was monitored with a computer-assisted sperm analyzer over 24 h. Additionally, the interaction with the spermatozoa was further investigated by means of light and transmission electron microscopy (TEM). Results Only viable Chlamydiae of both species decreased sperm motility and this only after about 9 h. Taking binding rates into account, the loss of sperm motility after about 9 h could likely be a consequence of Chlamydiae attachment to the spermatozoa. About two thirds of the Chlamydiae elementary bodies were bound to the front third of the sperm, the acrosomal region. No inclusions of Chlamydiae in spermatozoa were observed in TEM after 2 h co-incubation. Conclusions As initial motility was not affected following co-incubation of viable Chlamydiae and bovine sperm, it seems likely that sperm could serve as a carrier/vehicle for Chlamydiae facilitating cervical passage of Chlamydiae spp. in cattle. Additionally, our results suggest that spermatozoa carrying Chlamydiae may have no initial disadvantage in reaching the oviduct, but are immotile at the time of ovulation what might have an impact on fertilization capacities of the individual sperm. Consequently, high concentrations of the investigated Chlamydiae in the seminal plasma or female genital tract might play a role in reduced fertility in cattle.
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Affiliation(s)
- Thomas Eckert
- Klinikum Veterinärmedizin, Clinic for Obstetrics, Gynecology and Andrology of Large and Small Animals, Justus-Liebig University Giessen, Frankfurter Strasse 106, 35392, Giessen, Germany.,Institute for Veterinary-Physiology and Biochemistry, Justus-Liebig University Giessen, Frankfurter Strasse 100, 35392, Giessen, Germany
| | - Sandra Goericke-Pesch
- Klinikum Veterinärmedizin, Clinic for Obstetrics, Gynecology and Andrology of Large and Small Animals, Justus-Liebig University Giessen, Frankfurter Strasse 106, 35392, Giessen, Germany. .,Department of Veterinary Clinical Sciences, Section for Veterinary Reproduction and Obstetrics, University of Copenhagen, Dyrlægevej 68, 1870, Frederiksberg C, Denmark. .,Reproductive Unit of the Clinics - Clinic for Small Animals, University of Veterinary Medicine Hannover, Bünteweg 15, 30559, Hannover, Germany.
| | - Carsten Heydel
- Institute for Hygiene and Infectious Diseases of Animals, Justus-Liebig University Giessen, Frankfurter Strasse 85-89, 35392, Giessen, Germany
| | - Martin Bergmann
- Institute for Veterinary Anatomy, Histology and Embryology, Justus-Liebig University Giessen, Frankfurter Strasse 98, 35392, Giessen, Germany
| | - Johannes Kauffold
- Ambulatorische und Geburtshilfliche Tierklinik, Veterinärmedizinische Fakultät, University of Leipzig, An den Tierkliniken 29, 04103, Leipzig, Germany
| | - Klaus Failing
- Unit for Biomathematics and Data Processing, Justus-Liebig University Giessen, Frankfurter Str., 35392, Giessen, Germany
| | - Axel Wehrend
- Klinikum Veterinärmedizin, Clinic for Obstetrics, Gynecology and Andrology of Large and Small Animals, Justus-Liebig University Giessen, Frankfurter Strasse 106, 35392, Giessen, Germany
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Baud D, Vulliemoz N, Ammerdorffer A, Gyger J, Greub G, Castella V, Stojanov M. Waddlia chondrophila, a Chlamydia-related bacterium, has a negative impact on human spermatozoa. Hum Reprod 2019; 33:3-10. [PMID: 29145645 DOI: 10.1093/humrep/dex342] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 10/24/2017] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What is the impact of Waddlia chondrophila, an emerging Chlamydia-related bacterium associated with miscarriage, on human spermatozoa? SUMMARY ANSWER W. chondrophila had a negative impact on human spermatozoa (decrease in viability and mitochondrial membrane potential) and was not entirely removed from infected samples by density gradient centrifugation. WHAT IS KNOWN ALREADY Bacterial infection or colonization might have a deleterious effect on male fertility. Waddlia chondrophila was previously associated with miscarriage, but its impact on male reproductive function has never been studied. STUDY DESIGN SIZE, DURATION An in vitro model of human spermatozoa infection was used to assess the effects of W. chondrophila infection. Controls included Chlamydia trachomatis serovar D and latex beads with similar size to bacteria. PARTICIPANTS/MATERIALS, SETTING, METHODS Purified motile spermatozoa were infected with W. chondrophila (multiplicity of infection of 1). Immunohistochemistry combined with confocal microscopy was used to evaluate how bacteria interact with spermatozoa. The impact on physiology was assessed by monitoring cell viability, mitochondrial membrane potential and DNA fragmentation. MAIN RESULTS AND THE ROLE OF CHANCE Using super-resolution confocal microscopy, bacteria were localized on spermatozoa surface, as well as inside the cytoplasm. Compared to controls, W. chondrophila caused a 20% increase in mortality over 72 h of incubation (P < 0.05). Moreover, higher bacterial loads significantly reduced mitochondrial membrane potential. Bacteria present on spermatozoa surface were able to further infect a cell-monolayer, indicating that sperm might vector bacteria during sexual intercourse. LIMITATIONS REASONS FOR CAUTION The main limitation of the study is the use of an in vitro model of infection, which might be too simplistic compared to an actual infection. An animal model of infection should be developed to better evaluate the in vivo impact of W. chondrophila. WIDER IMPLICATIONS OF THE FINDINGS Intracellular bacteria, including C. trachomatis, Mycoplasma spp. and Ureaplasma spp., are associated with male infertility. Waddlia chondrophila might represent yet another member of this group, highlighting the need for more rigorous microbiological analysis during investigations for male infertility. STUDY FUNDING/COMPETING INTEREST(S) This work has been funded by the Department of Obstetrics and Gynecology, Lausanne University Hospital, Switzerland, and by the Swiss National Science Foundation (Grant nos. 310030-156169/1, 320030-169853/1 and 320030-169853/2 attributed to D.B.). D.B. is also supported by the 'Fondation Leenaards' through the 'Bourse pour la relève académique', by the 'Fondation Divesa' and by the 'Loterie Romande'. No conflicts of interest to declare.
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Affiliation(s)
- D Baud
- Materno-fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland
| | - N Vulliemoz
- Reproductive Medicine Unit, Department Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - A Ammerdorffer
- Materno-fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland
| | - J Gyger
- Materno-fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland
| | - G Greub
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - V Castella
- Forensic Genetics Unit, University Center of Legal Medicine, Lausanne, Geneva, Switzerland
| | - M Stojanov
- Materno-fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland
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15
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Stojanov M, Baud D, Greub G, Vulliemoz N. Male infertility: the intracellular bacterial hypothesis. New Microbes New Infect 2018; 26:37-41. [PMID: 30224969 PMCID: PMC6138880 DOI: 10.1016/j.nmni.2018.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/07/2018] [Accepted: 08/10/2018] [Indexed: 12/09/2022] Open
Abstract
Infertility is a disease that affects one in seven couples. As male infertility affects approximately 30% of these couples with an unknown cause in half the cases, it represents a major public health concern. The classic treatment of male infertility involves intrauterine insemination, with modest outcome, and in vitro fertilization with intracytoplasmic sperm injection, which is known to be invasive and expensive, without treating the specific cause of infertility. Male fertility is mainly evaluated through a semen assessment where abnormal parameters such as concentration and motility can be associated with a decreased chance of conception. Infectious processes represent plausible candidates for male infertility. Chlamydia trachomatis is well known to cause female infertility through tubal damage but its role in male infertility remains controversial. The link between ureaplasmas/mycoplasmas and male infertility is also debatable. The potential negative impact of these bacteria on male fertility might not only involve semen parameters but also, as with C. trachomatis, include important physiological mechanisms such as fertilization processes that are not routinely assessed during infertility investigation. Basic research is important to help determine the exact effect of these bacteria on male fertility to develop targeted treatment and go beyond in vitro fertilization with intracytoplasmic sperm injection.
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Affiliation(s)
- M Stojanov
- Materno-fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - D Baud
- Materno-fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - G Greub
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - N Vulliemoz
- Fertility Medicine and Gynaecological Endocrinology Unit, Department Woman-Mother-Child, Lausanne University Hospital, Switzerland
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17
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Moazenchi M, Totonchi M, Salman Yazdi R, Hratian K, Mohseni Meybodi MA, Ahmadi Panah M, Chehrazi M, Mohseni Meybodi A. The impact of Chlamydia trachomatis infection on sperm parameters and male fertility: A comprehensive study. Int J STD AIDS 2017; 29:466-473. [PMID: 29065772 DOI: 10.1177/0956462417735245] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chlamydia trachomatis (CT), an obligate intracellular bacterium, requires living cells to replicate. Half of men infected with CT are asymptomatic. CT infection can persist for up to four years within couples and affect their fertility. Chlamydia infection in men acts as a reservoir for transmission to women and can cause urinary tract inflammation, sperm DNA damage, and acute epididymitis. Semen samples from 1080 subfertile patients with normal and abnormal spermograms were examined to detect the presence of CT. An ELISA test was used to detect the presence of anti-CT IgA in these patients' seminal plasma. CT infection was also confirmed by molecular investigation using specific primers. In order to evaluate the effect of CT infections on the DNA Fragmentation Index (DFI), 40 CT-infected cases and 20 CT-negative controls were analyzed by a Sperm Chromatin Structure Assay using flow cytometry. Among 1080 patients with poor sperm parameters, 155 (14.3%) patients were diagnosed with CT, 11% among those with semen abnormalities and 26% among those without semen abnormalities patients. The DFI was statistically higher in cases than in controls (p < 0.05). Given the prevalence of infection and also the high frequency of asymptomatic CT infection among infertile individuals with poor sperm parameters, screening for infection in these patients is essential in order to avoid adverse sequelae. We propose that the higher rate of DFI in CT-infected infertile men might be an underlying cause of their infertility and this warrants greater attention.
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Affiliation(s)
- M Moazenchi
- 1 Department of Genetics, Reproductive Biomedicine Research Center, 48499 Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - M Totonchi
- 1 Department of Genetics, Reproductive Biomedicine Research Center, 48499 Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - R Salman Yazdi
- 2 Department of Andrology, Reproductive Biomedicine Research Center, 48499 Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - K Hratian
- 3 Department of Microbiology and Immunology, School of Medicine, Alborz University of Medical Sciences, Alborz University of Medical Sciences, Karaj, Iran
| | - M A Mohseni Meybodi
- 4 Department of Regenerative Biomedicine, Cell Science Research Center, 48499 Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - M Ahmadi Panah
- 1 Department of Genetics, Reproductive Biomedicine Research Center, 48499 Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - M Chehrazi
- 5 Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, 48499 Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - A Mohseni Meybodi
- 1 Department of Genetics, Reproductive Biomedicine Research Center, 48499 Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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18
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Qing L, Song QX, Feng JL, Li HY, Liu G, Jiang HH. Prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Ureaplasma urealyticum infections using a novel isothermal simultaneous RNA amplification testing method in infertile males. Ann Clin Microbiol Antimicrob 2017. [PMID: 28646898 PMCID: PMC5482940 DOI: 10.1186/s12941-017-0220-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to evaluate the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Ureaplasma urealyticum infections in infertile men that consulted our outpatient departments using a novel simultaneous amplification testing (SAT) that is RNA-detection based. The possible impact of C. trachomatis, N. gonorrhoeae, M. genitalium and U. urealyticum infections on semen parameters was also noted in the present study. Methods A total of 2607 males that were diagnosed with infertility were included in this study. C. trachomatis, N. gonorrhoeae, M. genitalium and U. urealyticum infections were detected in the urine samples using SAT method. Related data, including semen parameters and age as well as C. trachomatis, N. gonorrhoeae, M. genitalium and U. urealyticum infections were collected and analyzed. Results A total of 51 and 1418 urine samples were found positive for M. genitalium RNA and U. urealyticum RNA, respectively, while the prevalence of C. trachomatis and N. gonorrhoeae was relatively lower. Men with positive M. genitalium RNA and U. urealyticum RNA had higher sperm DNA fragmentation index (DFI) while the comparisons of other semen parameters yielded nonsignificant results between the RNA positive and negative group. A multivariate linear regression analysis revealed that U. urealyticum and M. genitalium infections posed significant factors of DFI (adjusted R2 = 46.2%). Conclusions Our study suggested a relative high prevalence of U. urealyticum and M. genitalium infection based on this novel SAT detection method. U. urealyticum and M. genitalium infection could possibly impair male fertility potential through promoting sperm DNA damage.
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Affiliation(s)
- Ling Qing
- Departments of Reproductive Medicine, Urology, and Nursing, The First Affiliated Hospital of Wenzhou Medical University, #2-4P07 Nan Bai Xiang, Ouhai, Wenzhou, 325000, Zhejiang, China
| | - Qi-Xiang Song
- Department of Urology, Changhai Hospital, Shanghai, 200433, China
| | - Jian-Li Feng
- Department of Urology, The 324 Hospital of PLA, Chongqing, 400020, China
| | - Hai-Yan Li
- Departments of Reproductive Medicine, Urology, and Nursing, The First Affiliated Hospital of Wenzhou Medical University, #2-4P07 Nan Bai Xiang, Ouhai, Wenzhou, 325000, Zhejiang, China
| | - Guiming Liu
- Department of Surgery/Urology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, 44109, USA
| | - Hai-Hong Jiang
- Departments of Reproductive Medicine, Urology, and Nursing, The First Affiliated Hospital of Wenzhou Medical University, #2-4P07 Nan Bai Xiang, Ouhai, Wenzhou, 325000, Zhejiang, China.
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19
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Fode M, Fusco F, Lipshultz L, Weidner W. Sexually Transmitted Disease and Male Infertility: A Systematic Review. Eur Urol Focus 2016; 2:383-393. [DOI: 10.1016/j.euf.2016.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 07/08/2016] [Accepted: 08/04/2016] [Indexed: 12/09/2022]
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20
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Sobinoff AP, Dando SJ, Redgrove KA, Sutherland JM, Stanger SJ, Armitage CW, Timms P, McLaughlin EA, Beagley KW. Chlamydia muridarum infection-induced destruction of male germ cells and sertoli cells is partially prevented by Chlamydia major outer membrane protein-specific immune CD4 cells. Biol Reprod 2014; 92:27. [PMID: 25472923 DOI: 10.1095/biolreprod.114.124180] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Chlamydia trachomatis infections are increasingly prevalent worldwide. Male chlamydial infections are associated with urethritis, epididymitis, and orchitis; however, the role of Chlamydia in prostatitis and male factor infertility remains controversial. Using a model of Chlamydia muridarum infection in male C57BL/6 mice, we investigated the effects of chlamydial infection on spermatogenesis and determined the potential of immune T cells to prevent infection-induced outcomes. Antigen-specific CD4 T cells significantly reduced the infectious burden in the penile urethra, epididymis, and vas deferens. Infection disrupted seminiferous tubules, causing loss of germ cells at 4 and 8 wk after infection, with the most severely affected tubules containing only Sertoli cells. Increased mitotic proliferation, DNA repair, and apoptosis in spermatogonial cells and damaged germ cells were evident in atrophic tubules. Activated caspase 3 (casp3) staining revealed increased (6-fold) numbers of Sertoli cells with abnormal morphology that were casp3 positive in tubules of infected mice, indicating increased levels of apoptosis. Sperm count and motility were both decreased in infected mice, and there was a significant decrease in morphologically normal spermatozoa. Assessment of the spermatogonial stem cell population revealed a decrease in promyelocytic leukemia zinc finger (PLZF)-positive cells in the seminiferous tubules. Interestingly, adoptive transfer of antigen-specific CD4 cells, particularly T-helper 2-like cells, prior to infection prevented these effects in spermatogenesis and Sertoli cells. These data suggest that chlamydial infection adversely affects spermatogenesis and male fertility, and that vaccination can potentially prevent the spread of infection and these adverse outcomes.
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Affiliation(s)
- Alexander P Sobinoff
- Priority Research Centres in Chemical Biology and Reproductive Science, School of Environmental & Life Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Samantha J Dando
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kate A Redgrove
- Priority Research Centres in Chemical Biology and Reproductive Science, School of Environmental & Life Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Jessie M Sutherland
- Priority Research Centres in Chemical Biology and Reproductive Science, School of Environmental & Life Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Simone J Stanger
- Priority Research Centres in Chemical Biology and Reproductive Science, School of Environmental & Life Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Charles W Armitage
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Peter Timms
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Eileen A McLaughlin
- Priority Research Centres in Chemical Biology and Reproductive Science, School of Environmental & Life Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Kenneth W Beagley
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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Male infertility: a public health issue caused by sexually transmitted pathogens. Nat Rev Urol 2014; 11:672-87. [PMID: 25330794 DOI: 10.1038/nrurol.2014.285] [Citation(s) in RCA: 134] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Sexually transmitted diseases (STDs) are caused by several pathogens, including bacteria, viruses and protozoa, and can induce male infertility through multiple pathophysiological mechanisms. Additionally, horizontal transmission of STD pathogens to sexual partners or vertical transmission to fetuses and neonates is possible. Chlamydia trachomatis, Ureaplasma spp., human papillomavirus, hepatitis B and hepatitis C viruses, HIV-1 and human cytomegalovirus have all been detected in semen from symptomatic and asymptomatic men with testicular, accessory gland and urethral infections. These pathogens are associated with poor sperm quality and decreased sperm concentration and motility. However, the effects of these STD agents on semen quality are unclear, as are the effects of herpes simplex virus type 1 and type 2, Neisseria gonorrhoeae, Mycoplasma spp., Treponema pallidum and Trichomonas vaginalis, because few studies have evaluated the influence of these pathogens on male infertility. Chronic or inadequately treated infections seem to be more relevant to infertility than acute infections are, although in many cases the exact aetiological agents remain unknown.
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Sellami H, Znazen A, Sellami A, Mnif H, Louati N, Zarrouk SB, Keskes L, Rebai T, Gdoura R, Hammami A. Molecular detection of Chlamydia trachomatis and other sexually transmitted bacteria in semen of male partners of infertile couples in Tunisia: the effect on semen parameters and spermatozoa apoptosis markers. PLoS One 2014; 9:e98903. [PMID: 25019616 PMCID: PMC4096407 DOI: 10.1371/journal.pone.0098903] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 05/08/2014] [Indexed: 11/19/2022] Open
Abstract
This study was undertaken to determine the prevalence of Chlamydia trachomatis, Mycoplasmas, and Ureaplasmas in semen samples of the male partners of infertile couples and to investigate whether Chlamydia trachomatis could initiate apoptosis in human spermatozoa. A total of 85 males partners of infertile couples undergoing routine semen analysis according to World Health Organization guidelines were included. Specimens were examined for the presence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum and Ureaplasma parvum by Real time PCR (qPCR). Semen specimens were analysed for the appearance of apoptotic markers (sperm DNA fragmentation, activated caspase 3 levels, mitochondrial membrane potential (ΔΨm)) using flow cytometry. C. trachomatis, N. gonorrhoeae, U. urealyticum, M genitalium were detected in semen samples of 13 (15.2%), 5 (5.8%), 5 (5.8%) and 3 (3.5%) male partners of infertile couples, respectively. M. hominis and U. parvum were detected in semen sample of only one patient (1.1%). The semen of infertile men positive for C. trachomatis showed lower mean of semen count and lower rapid progressive motility (category [a]) of spermatozoa compared to uninfected men with statistically significances (p = 0.02 and p = 0.04, respectively). Flow cytometry analyses demonstrated a significant increase of the mean rate of semen with low ΔΨm and caspase 3 activation of infertile men positive for C. trachomatis compared to uninfected men (p = 0.006 and p = 0.001, respectively). DNA fragmentation was also increased in sperm of infertile men positive for C. trachomatis compared to uninfected men but without statistical significances (p = 0.62). Chlamydial infection was associated to loss of ΔΨm and caspase 3activation. Thus, C. trachomatis infection could be incriminated in apoptosis induction of spermatozoa. These effects may explain the negative direct impact of C. trachomatis infection on sperm fertilizing ability.
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Affiliation(s)
- Hanen Sellami
- Department of Microbiology and research laboratory “Microorganismes et Pathologies Humaines”, Habib Bourguiba University Hospital of Sfax, Sfax, Tunisia
| | - Abir Znazen
- Department of Microbiology and research laboratory “Microorganismes et Pathologies Humaines”, Habib Bourguiba University Hospital of Sfax, Sfax, Tunisia
| | - Afifa Sellami
- Histology Embryology Research Unit, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Hela Mnif
- Sfax Regional Center of Blood Transfusion, Sfax, Tunisia
| | - Nour Louati
- Sfax Regional Center of Blood Transfusion, Sfax, Tunisia
| | - Soumaya Ben Zarrouk
- Histology Embryology Research Unit, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Leila Keskes
- Histology Embryology Research Unit, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Tarek Rebai
- Histology Embryology Research Unit, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Radhouane Gdoura
- Unit Research of Toxicology-Microbiology Environmental and Health, Sciences Faculty of Sfax, University of Sfax, Sfax, Tunisia
| | - Adnene Hammami
- Department of Microbiology and research laboratory “Microorganismes et Pathologies Humaines”, Habib Bourguiba University Hospital of Sfax, Sfax, Tunisia
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Herwig R, Knoll C, Planyavsky M, Pourbiabany A, Greilberger J, Bennett KL. Proteomic analysis of seminal plasma from infertile patients with oligoasthenoteratozoospermia due to oxidative stress and comparison with fertile volunteers. Fertil Steril 2013; 100:355-66.e2. [DOI: 10.1016/j.fertnstert.2013.03.048] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 03/14/2013] [Accepted: 03/29/2013] [Indexed: 12/12/2022]
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Agarwal A, Sekhon LH. Oxidative stress and antioxidants for idiopathic oligoasthenoteratospermia: Is it justified? Indian J Urol 2011; 27:74-85. [PMID: 21716893 PMCID: PMC3114591 DOI: 10.4103/0970-1591.78437] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Oxidative stress contributes to defective spermatogenesis and the poor quality of sperm associated with idiopathic male factor infertility. The aim of this study was to review the current literature on the effects of various types of antioxidant supplements in patients to improve fertilization and pregnancy rates in subfertile males with idiopathic oligoasthenoteratozoospermia (iOAT). Review of recent publications through PubMed and the Cochrane database. Oxidative stress is implicated in impaired spermatogenesis leading to the poor semen parameters and increased DNA damage and apoptosis in iOAT. Strategies to modulate the level of oxidative stress within the male reproductive tract include the use of oral antioxidant compounds to reinforce the body's defence against oxidative damage. In our evaluation, carnitines were considered the most established pharmacotherapeutic agent to treat iOAT, as evidence and data concerning carnitine supplementation have been shown to be most consistent and relevant to the population of interest. Other therapies, such as combined vitamin E and C therapy, are still considered controversial as vitamin C can act as a pro-oxidant in certain instances and the results of randomized controlled trials have failed to show significant benefit to sperm parameters and pregnancy rates. There is a need for further investigation with randomized controlled studies to confirm the efficacy and safety of antioxidant supplementation in the medical treatment of idiopathic male infertility as well as the need to determine the dosage required to improve semen parameters, fertilization rates and pregnancy outcomes in iOAT.
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Affiliation(s)
- Ashok Agarwal
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, USA
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Salmeri M, Santanocita A, Toscano MA, Morello A, Valenti D, La Vignera S, Bellanca S, Vicari E, Calogero AE. Chlamydia trachomatis prevalence in unselected infertile couples. Syst Biol Reprod Med 2010; 56:450-6. [PMID: 20849228 DOI: 10.3109/19396361003792853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Chlamydia (C.) trachomatis, an obligate intracellular bacterium, is responsible for the most common sexual transmitted disease and infertility. The purpose of this study was to evaluate: a) the frequency of chlamydial infection in unselected infertile couples and b) whether chlamydial infection could be identified in the semen sample as effectively as in the urethral swab of infertile patients. To accomplish this, 73 unselected, consecutive infertile couples were enrolled. Both male and female partners underwent a complete work-up to identify the cause of their infertility. A PCR method was used to detect C. trachomatis in urethral swabs and the semen samples of the male partners and in the cervical swabs of the female partners. C. trachomatis infection was found in 6 couples (8.2%). Three couples had both partners infected, 2 couples had only the male partner infected, and 1 only the female partner. C. trachomatis infection was found in the urethral swab of all 5 men infected, whereas the bacterial DNA was found in the semen sample of 2 of them. These findings suggest that C. trachomatis infection is present in about 8% of unselected infertile couples and that the bacterium should be searched in the male partner urethral swab which has a higher sensitivity.
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Affiliation(s)
- Mario Salmeri
- Department of Microbiological and Gynaecological Sciences, University of Catania, via Androne 81, Catania, Italy.
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Abstract
UNLABELLED Human reproduction provides unique opportunities for the transmission of infectious agents. Furthermore, the mother and her offspring have distinct susceptibilities to infection at each stage of reproduction, from conception and gestation to parturition and the neonatal period. The impact of pathogens on reproduction can be mitigated or exacerbated depending on timing of acquisition during pregnancy. Similarly, factors such as maternal immune response, nutritional status, or concurrent infection may modify the effect of an infectious agent. In this review, we discuss the evidence--or lack thereof--for associations between infectious agents and reproductive problems at each stage of reproduction. We focus on well-substantiated associations, and consider several emerging or controversial associations. We discuss the challenges, limitations, and opportunities related to epidemiologic research on infectious disease and reproductive outcomes. TARGET AUDIENCE Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES After completion of this article, the reader will be able to describe the potential mechanisms by which infectious agents may impact productive health, explain the public health impact of infectious diseases on reproductive health, and summarize the perinatal risks of infectious disease and relate this to treatment and prevention strategies in practice.
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Al-Mously N, Cross NA, Eley A, Pacey AA. Real-time polymerase chain reaction shows that density centrifugation does not always remove Chlamydia trachomatis from human semen. Fertil Steril 2009; 92:1606-15. [DOI: 10.1016/j.fertnstert.2008.08.128] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Revised: 08/16/2008] [Accepted: 08/27/2008] [Indexed: 11/28/2022]
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Gallegos G, Ramos B, Santiso R, Goyanes V, Gosálvez J, Fernández JL. Sperm DNA fragmentation in infertile men with genitourinary infection by Chlamydia trachomatis and Mycoplasma. Fertil Steril 2008; 90:328-34. [PMID: 17953955 DOI: 10.1016/j.fertnstert.2007.06.035] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Revised: 06/12/2007] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the frequency of sperm cells with fragmented DNA in semen samples from men with genitourinary infection by Chlamydia trachomatis and Mycoplasma and the influence of antibiotic therapy, using the sperm chromatin dispersion test with the Halosperm kit. DESIGN Prospective study. SETTING University-affiliated reproductive medicine center, medical genetics laboratory, and academic biology center. PATIENT(S) One hundred forty-three male member of couples attending the andrology infertility center and a group of 50 fertile subjects. The effect of antibiotic treatment was evaluated in 95 male patients. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Classical semen analysis (concentration, motility, morphology, and vitality), sperm DNA fragmentation, and clinical outcome. RESULT(S) The mean percentage of sperm cells with fragmented DNA was 35.2% +/- 13.5%, 3.2 times higher than in the control fertile group (10.8% +/- 5.6%). Concentration, morphology, and motility were also significantly affected but to a much lower degree. Sperm vitality was not significantly affected. After 3.8 +/- 2.2 months of antibiotic treatment, the mean frequency of spermatozoa with fragmented DNA decreased from 37.7% +/- 13.6% to 24.2% +/- 11.2%. Sperm concentration and motility were not significantly improved. In a group of 16 couples who attempted pregnancy during antibiotic treatment course, only 12.5% achieved pregnancy. However, in a group of 14 couples who attempted pregnancy after finishing the antibiotic treatment, 85.7% achieved it. The only significant differences found between groups was the rate of sperm DNA fragmentation and morphology. CONCLUSION(S) Patients with genitourinary infection by Chlamydia trachomatis and Mycoplasma have increased sperm DNA fragmentation in comparison with fertile controls. This increase is proportionally greater than the influence on classical semen parameters and could result in a decreased fertility potential. Antibiotic therapy appears to be important in providing a remedy for infection-induced high DNA fragmentation levels.
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Affiliation(s)
- Guadalupe Gallegos
- Facultad de Medicina, Universidad Autónoma de Nuevo León, Nuevo León, México
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Cunningham KA, Beagley KW. Male Genital Tract Chlamydial Infection: Implications for Pathology and Infertility1. Biol Reprod 2008; 79:180-9. [DOI: 10.1095/biolreprod.108.067835] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Rignell-Hydbom A, Axmon A, Lundh T, Jönsson BA, Tiido T, Spano M. Dietary exposure to methyl mercury and PCB and the associations with semen parameters among Swedish fishermen. Environ Health 2007; 6:14. [PMID: 17488503 PMCID: PMC1871583 DOI: 10.1186/1476-069x-6-14] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Accepted: 05/08/2007] [Indexed: 05/15/2023]
Abstract
Dietary POP exposure have shown negative effects on sperm motility and sperm chromatin integrity, as well as an increased proportion of Y-chromosome bearing sperms. However, it has been suggested that in epidemiological studies investigating persistent organochlorine pollutant (POP)-toxicity, other pollutants occurring simultaneously may carry an increased risk of effects, which may obscure a clear interpretation of the role of POP toxicity. One such pollutant is methyl mercury (MeHg), which has been found in fatty fish from the Baltic Sea and as a consequence men with a high consumption of such fish has been found to have twice the MeHg levels compared to men with a low fish consumption. The aim of the present study was to assess if exposure to MeHg affects male reproductive function, assessed by measuring human sperm motility, sperm concentration, total sperm count, sperm chromatin integrity and the proportion of Y-chromosome bearing sperms. Secondly we also investigated a possible interaction between MeHg and 2, 2', 4, 4', 5, 5'-hexachlorobiphenyl (CB-153), a biomarker for POP exposure, with respect to sperm outcome measures. Blood and semen samples were collected from 195 Swedish fishermen with a mean age of 47 (range 24-67 years). Blood levels of MeHg ranged from 0.11 to 16.59 microg/L (median 2.25 microg/L) and serum levels of CB-153 from 37 to 1460 ng/g lipid (median 190 ng/g lipid). The analyses revealed no association between MeHg and any of the outcomes investigated. Although men with low MeHg and high CB-153 had slightly higher DNA Fragmentation Index and fraction of Y-chromosome bearing sperms than men with low levels of both compounds, the effects were not statistically significant. In conclusion, we did not find any associations between MeHg exposure and semen quality or quantity in the dose range observed neither was any synergistic effects between MeHg and CB-153 noted.
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Affiliation(s)
- Anna Rignell-Hydbom
- Division of Occupational and Environmental Medicine and Psychiatric Epidemiology, Department of Laboratory Medicine, Lund University Hospital, SE-221 85 Lund, Sweden
| | - Anna Axmon
- Division of Occupational and Environmental Medicine and Psychiatric Epidemiology, Department of Laboratory Medicine, Lund University Hospital, SE-221 85 Lund, Sweden
| | - Thomas Lundh
- Division of Occupational and Environmental Medicine and Psychiatric Epidemiology, Department of Laboratory Medicine, Lund University Hospital, SE-221 85 Lund, Sweden
| | - Bo A Jönsson
- Division of Occupational and Environmental Medicine and Psychiatric Epidemiology, Department of Laboratory Medicine, Lund University Hospital, SE-221 85 Lund, Sweden
| | - Tarmo Tiido
- Fertility Centre, Scanian Andrology Centre, Malmö University Hospital, Lund University, SE-205 02 Malmö, Sweden
| | - Marcello Spano
- Section of Toxicology and Biomedical Sciences, ENEA CR Casaccia, Rome, Italy
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Bezold G, Politch JA, Kiviat NB, Kuypers JM, Wolff H, Anderson DJ. Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia. Fertil Steril 2007; 87:1087-97. [PMID: 17433312 PMCID: PMC2697906 DOI: 10.1016/j.fertnstert.2006.08.109] [Citation(s) in RCA: 147] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2006] [Revised: 08/08/2006] [Accepted: 08/08/2006] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the prevalence of pathogens that cause sexually transmitted infections (STIs) in semen from asymptomatic male infertility patients with and without leukocytospermia (LCS), and associations between STIs, inflammatory markers, and other semen variables. DESIGN Retrospective, controlled study. SETTING Academic Medical Center. PATIENT(S) Two hundred and forty-one male infertility patients undergoing routine semen analysis: 132 with LCS, and 109 without LCS. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The DNA from STI pathogens (human papillomavirus [HPV], cytomegalovirus [CMV], herpes simplex virus [HSV], human herpesvirus type 6 [HHV-6], Epstein-Barr virus [EBV], hepatitis B virus [HBV], and Chlamydia trachomatis [CT]), routine semen parameters, and markers of accessory gland and epididymal function and inflammation. RESULT(S) The DNA from STI pathogens was detected in 45/241 (18.7%) of the samples (CMV, 8.7%; HPV, 4.5%; HHV-6, 3.7%; HSV, 3.7%; CT, 2.5%; EBV, 0.4%; and HBV, 0%), with no difference in prevalence between the LCS and non-LCS groups. The DNA of STI pathogens in semen was associated with a decrease in sperm concentration, motile sperm concentration, total sperm count, and neutral alpha-glucosidase concentration, whereas LCS was associated with a decrease in total sperm count, percent normal forms, and fructose concentration. CONCLUSION(S) The DNA of STI pathogens was detected in semen from a high percentage of asymptomatic male infertility patients, and was associated with poor semen quality. Efforts to diagnose and treat subclinical genital-tract infections should be intensified.
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Affiliation(s)
- Guntram Bezold
- Fearing Research Laboratory, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Idahl A, Abramsson L, Kumlin U, Liljeqvist JA, Olofsson JI. Male serum Chlamydia trachomatis IgA and IgG, but not heat shock protein 60 IgG, correlates with negatively affected semen characteristics and lower pregnancy rates in the infertile couple. ACTA ACUST UNITED AC 2006; 30:99-107. [PMID: 17132153 DOI: 10.1111/j.1365-2605.2006.00718.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The objective of this study was to evaluate whether serum Chlamydia trachomatis immunoglobulin-A (IgA), IgM and C. trachomatis heat shock protein 60 (CHSP60) IgG are of additional value to C. trachomatis IgG regarding the impact on fecundity in infertile couples, and to relate C. trachomatis serum antibodies to semen characteristics, diagnoses and pregnancy outcome. METHODS A total of 226 infertile couples, previously tested for C. trachomatis IgG, were tested for C. trachomatis IgA, IgM and CHSP60 IgG, and semen samples from all men were analysed. RESULTS Chlamydia trachomatis serum IgA in men (but not in women) correlated with reduced chances of achieving pregnancy [p = 0.021, relative risk (RR) =0.65, 95% confidence interval (CI) 0.42-1.005] and in combination with C. trachomatis IgG the chance was further reduced (p =0.001, RR = 0.35, 95% CI 0.15-0.84). Chlamydia trachomatis serum IgA was also significantly correlated with reduced motility of the spermatozoa (-8.7%, p = 0.023), increased number of dead spermatozoa (+10.5%, p = 0.014) and higher prevalence of leucocytes in semen (+122%, p = 0.005), and in combination with C. trachomatis IgG positivity, there was also a decrease in sperm concentration (-35%, p = 0.033), the number of progressive spermatozoa (-14.8%, p = 0.029) and a rise in the teratozoospermia index (+4.4%, p = 0.010). CHSP60 IgG correlated with reduced motility (-5.6%, p = 0.033), and in the women to tubal factor infertility (p = 0.033), but no correlations of C. trachomatis serum IgM or CHSP60 IgG with pregnancy rates were found. CONCLUSIONS Chlamydia trachomatis serum IgA in the male partner of the infertile couple has an additive value to IgG in predicting pregnancy chances, and serum IgA and IgG are associated with subtle negative changes in semen characteristics.
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Affiliation(s)
- A Idahl
- Department of Clinical Science/Obstetrics and Gynecology, Umeå University, Umeå, Sweden.
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Abstract
Idiopathic oligoasthenoteratozoospermia (iOAT) affects approximately 30% of all infertile men. This mini-review discussed recent data in this field. Age, non-inflammatory functional alterations in post-testicular organs, infective agents (Chlamydia trachomatis, herpes virus and adeno-associated viruses), alterations in gamete genome, mitochondrial alterations, environmental pollutants and "subtle" hormonal alterations are all considered possible causes of iOAT. Increase of reactive oxygen species in tubules and in seminal plasma and of apoptosis are reputed to affect sperm concentration, motility and morphology. iOAT is commonly diagnosed by exclusion, nevertheless spectral traces of the main testicular artery may be used as a diagnostic tool for iOAT. The following can be considered therapies for iOAT: 1) tamoxifen citrate (20 mg/d) + testosterone undecanoate (120 mg/d) (pregnancy rate per couple/month [prcm]: 3.8%); 2) folic acid (66 mg/d) + zinc sulfate (5 mg/d); 3) L-carnitine (2 g/d) alone or in combination with acetyl-L-carnitine (1 g/d) (prcm: 2.3%); and 4) both carnitines = one 30 mg cinnoxicam suppository every 4 days (prcm: 8.5%). Alpha-blocking drugs improved sperm concentration but not morphology, motility or pregnancy rate. Tranilast (300 mg/d) increased sperm parameters and pregnancy rates in an initial uncontrolled study. Its efficacy on sperm concentration (but not on sperm motility, morphology or prcm) was confirmed in subsequent published reports. The efficacy of tamoxifen + testosterone undecanoate, tamoxifen alone, and recombinant follicle-stimulating hormone is still a matter for discussion.
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Affiliation(s)
- Giorgio Cavallini
- Operative Unit of Andrology, Società Italiana di Medicina della Riproduzione, Via Mazzini 12, 40138 Bologna, Italy.
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Affiliation(s)
- Florian M E Wagenlehner
- Urological Clinic, Hospital St. Elisabeth, St. Elisabeth Strasse 23, D-94315 Straubing, Germany.
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Sule-Odu AO, Oladapo OT, Jagun OE, Awosile J. Microbial isolates and HIV infection in couples attending fertility clinics in Sagamu, Nigeria. J OBSTET GYNAECOL 2006; 25:685-8. [PMID: 16263544 DOI: 10.1080/01443610500292221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This observational study was designed to determine the prevalence of HIV infection and the microbial isolates from the genital tracts of couples attending the fertility clinics of Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria between January 2001 and December 2002. A total of 110 women and 49 of their male partners were recruited into the study. The majority of the patients were between 25 and 34 years (women: 71.8%; partners: 65.3%), though the men were significantly older than the women (p < 0.001). The overall prevalence of HIV infection in those who consented to screening was 8.2%, which was over twice the reported prevalence among the general population in Ogun State, Nigeria during the study period. Candida albicans (32.5%) and Staphylococcus aureus (27.5%) were the most frequently isolated microorganisms from the endocervix while Trichomonas vaginalis (37.9%) and Staphylococcus aureus (24.1%) were the most common microbes isolated from the posterior vaginal fornix. Of all the seminal qualities, only the volume showed a significant difference between the infected and non-infected samples (p < 0.004). This study suggests a higher prevalence of HIV infection among the infertile couples in our environment and it may be advisable to have them screened for HIV in the face of the present HIV situation in sub-Saharan Africa.
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Affiliation(s)
- A O Sule-Odu
- Department of Obstetrics and Gynaecology, Olabisi Onabanjo University Teaching Hospital, Ogun State, Nigeria.
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Wagenlehner FME, Weidner W, Naber KG. Chlamydial infections in urology. World J Urol 2006; 24:4-12. [PMID: 16421732 DOI: 10.1007/s00345-005-0047-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2005] [Accepted: 11/07/2005] [Indexed: 10/25/2022] Open
Abstract
Chlamydia trachomatis is the most frequent cause for sexually transmitted diseases in European countries. The organism has an intracellular habitat with a very specific life cycle. A variety of diagnostic tests have been developed with different sensitivity and specificity. Interpretation of these tests can sometimes be difficult. Diseases caused by C. trachomatis in men comprise urethritis, prostatitis, epididymitis, infertility and reactive arthritis. Especially in prostatitis, the exact role of C. trachomatis is still under debate for the technical difficulties localizing the pathogen to the prostate. For treatment, only some antibiotics are effective because of the intracellular habitat of the pathogen. Prevention of infection comprises treatment and screening efforts.
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Satta A, Stivala A, Garozzo A, Morello A, Perdichizzi A, Vicari E, Salmeri M, Calogero AE. Experimental Chlamydia trachomatis infection causes apoptosis in human sperm. Hum Reprod 2005; 21:134-7. [PMID: 16126752 DOI: 10.1093/humrep/dei269] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Chlamydia trachomatis is responsible for a widespread sexually transmitted infection. In men, it is associated with a wide clinical spectrum causing infertility. Furthermore, C. trachomatis serovar E infection decreases motility and increases the number of non-viable sperm. No other effects of C. trachomatis have been reported on sperm despite the crucial role of DNA integrity for sperm function. The aim of this study was to investigate the effects of C. trachomatis on sperm apoptosis. METHODS Sperm from eight normozoospermic men were incubated with increasing concentrations of C. trachomatis serovar E elementary bodies (EB) for 6 and 24 h. Sperm were then collected to evaluate phosphatidylserine (PS) membrane translocation and DNA fragmentation by Annexin V-propidium iodide staining, TUNEL assay and flow cytometry. RESULTS After 6 h of incubation, C. trachomatis had no effect on the percentage of sperm showing PS externalization. However, a significant effect on this parameter was observed after 24 h. C. trachomatis also significantly increased the number of sperm with DNA fragmentation both after 6 and 24 h of incubation. CONCLUSIONS C. trachomatis causes sperm PS externalization and DNA fragmentation. These effects may explain the negative direct impact of C. trachomatis infection on sperm fertilizing ability.
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Affiliation(s)
- Annalisa Satta
- Section of Endocrinology, Andrology and Internal Medicine and Master in Andrological and Human Reproduction Sciences, University of Catania, Catania, Italy
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