CagA-positive Helicobacter pylori infection and reduced sperm motility, vitality, and normal morphology. Dis Markers. 2013;35:229-234. [PMID: 24167371 DOI: 10.1155/2013/919174]

Sperm parameters and anti-Müllerian hormone remain stable with Helicobacter pylori infection: a cross-sectional study

BACKGROUND AND AIMS

It has been reported that Helicobacter pylori (HP) infection was more prevalent in infertile populations. HP infection could lead to decreased sperm parameters, and treating the HP infection could improve the quality of sperm. However, studies investigating the relationship between infertility and HP infection are still limited, and more evidence is required. Therefore, we performed the present study to investigate the impact of HP infection on sperm quality in males and on ovarian reserve in females.

METHODS

A total of 16,522 patients who visited the Second Hospital of Zhejiang University from January 2016 to June 2019 due to abdominal discomfort and underwent a ^13/14C-urea breath HP test were included in this retrospective cross-sectional study. Among them, 565 had performed sperm analysis or ovarian reserve tests in the past three months and were involved for further analyses. Sperm parameters were examined with a computer-assisted sperm analysis system, and serum anti-Müllerian hormone (AMH) and sex hormones were tested with an electrochemiluminescence method.

RESULTS

Among 363 patients who underwent the sperm test, 136 (37.47%) had HP infection. Among 202 patients who underwent the AMH test, 55 (27.23%) had HP infection. There was no difference in sperm concentration and motility between the HP+ and HP- groups (P > 0.05). Further subgroup analyses stratified into 5-year age groups confirmed that there was no significant difference in sperm parameters (P > 0.05). When pooled with previously published data, no significant difference in sperm concentration or motility was found (P > 0.05). Meanwhile, this study found that the serum AMH level was similar between the HP+ and HP- groups (P > 0.05). Further subgroup analyses confirmed that there was no significant difference in serum AMH level (P > 0.05).

CONCLUSIONS

There were no differences in sperm parameters and AMH levels based on history of HP infection among Chinese patients.

Infectious Burden and Semen Parameters

OBJECTIVE

To investigate the relationship between chronic infections detected in serum and semen quality. The pathogen burden is a concept consisting in the observation that, in patients with heart disease, damaging effects of the coronary arteries increase concomitantly with the number of agents responsible for chronic infections to which patients mounted a serological response. Previous observations that Helicobacter pylori infection may reduce the semen quality prompted us to perform the present study.

METHODS

Blood and semen samples were collected from 73 selected men, enrolled from January 2014 to January 2015. Semen characteristics were evaluated by light and transmission electron microscopy. Transmission electron microscopy data were quantified with a mathematical formula providing numerical scores, such as fertility index (FI, number of sperm free from ultrastructural defects) and the percentages of sperm apoptosis, immaturity, and necrosis. Serum samples were examined by enzyme-linked immunosorbent assay for the presence of immunoglobulin G to the most common agents of chronic infections such as H. pylori (HP), Mycoplasma pneumoniae (MP), Chlamydophila pneumoniae (CP), Epstein-Barr virus (EBV), herpes simplex virus 1 (HSV-1), and cytomegalovirus (CMV).

RESULTS

The prevalence of infections was as follows: HP 43.8%, CP 46.6%, MP 72.6%, EBV 95.9%, HSV-1 74.0%, and CMV 46.6%. Concomitantly with the increased number of pathogens against which the patients mounted a significant antibody response, sperm concentration (P <.05), sperm motility (P <.001), and fertility index (P <.001) were significantly reduced and the percentage of necrotic sperm was increased (P <.01).

CONCLUSION

The higher the number of pathogens stimulating an immunoglobulin G systemic response, the lower was the semen quality.

Seminal Helicobacter pylori treatment improves sperm motility in infertile asthenozoospermic men

OBJECTIVE

To assess the effect of treatment of seminal Helicobacter pylori in infertile asthenozoospermic men.

METHODS

In all, 223 infertile asthenozoospermic men were consecutively selected. They were subjected to history taking, clinical examination, semen analysis, and estimation of H pylori IgA antibodies in their seminal fluid. Infertile men with high seminal H pylori IgA were subjected to triple drug treatment, omeprazole, 20 mg; tinidazole, 500 mg; and clarithromycin, 250 mg twice a day for 2 weeks. Semen analysis as well as H pylori IgA antibodies was estimated after 3 months.

RESULTS

In all, 22 of 223 men (9.87%) demonstrated H pylori IgA antibodies in their seminal plasma. After treatment, mean seminal H pylori IgA levels demonstrated significant decrease (1.55 ± 0.4 vs 0.52 ± 0.26; 95% confidence interval, 0.83-1.21; P = .001) concomitant with improved progressive as well as nonprogressive sperm motility. H pylori IgA antibodies demonstrated significant negative correlation with progressive sperm motility, nonprogressive sperm motility, normal sperm morphology, and significant positive correlation with immotile sperm motility.

CONCLUSION

H pylori treatment significantly improves sperm motility in infertile asthenozoospermic men with elevated seminal H pylori IgA.

Helicobacter pylori and extragastric diseases

While Helicobacter pylori infection was initially revealed to be associated only with some gastroduodenal diseases, further studies have shown its possible role in several extragastric diseases. For idiopathic thrombocytopenic purpura, sideropenic anemia, and vitamin B12 deficiency, the diagnosis of H. pylori infection is recommended, and there are many other conditions such as cardiovascular, neurological, dermatological, and respiratory diseases in which H. pylori may possibly play a role. Interestingly, a potential role has also been described for GI neoplastic diseases, including colorectal and pancreatic cancer. Different mechanisms of action have been proposed, ranging from the induction of a low grade inflammatory state to the occurrence of molecular mimicry mechanisms. This review summarizes the results of the most relevant studies published on this topic over the last year.

Can Helicobacter pylori infection influence human reproduction?

Helicobacter pylori (H. pylori) infection could be associated with extra-digestive diseases. Here, we report the evidences concerning the decrease in reproductive potential occurring in individuals infected by H. pylori, especially by strains expressing CagA. This infection is more prevalent in individuals with fertility disorders. Infected women have anti-H. pylori antibodies in cervical mucus and follicular fluid that may decrease sperm motility and cross react immunologically with spermatozoa, conceivably hampering the oocyte/sperm fusion. Infection by CagA positive organisms enhances the risk of preeclampsia, which is a main cause of foetus death. These findings are supported by the results of experimental infections of pregnant mice, which may cause reabsorption of a high number of foetuses and alter the balance between Th1 and Th2 cell response. Infected men have decreased sperm motility, viability and numbers of normally shaped sperm and augmented systemic levels of inflammatory cytokines, such as tumor necrosis factor-α, which may damage spermatozoa. In countries where parasitic infestation is endemic, detrimental effects of infection upon spermatozoa may not occur, because the immune response to parasites could determine a switch from a predominant Th1 type to Th2 type lymphocytes, with production of anti-inflammatory cytokines. In conclusion, the evidences gathered until now should be taken into consideration for future studies aiming to explore the possible role of H. pylori infection on human reproduction.