To study the impact of asymptomatic semen infections on seminal parameters in men presenting for primary couple's infertility.
Cross-sectional study.
Academic center.
Socio-demographic, clinical, and laboratory data from 1689 infertile men were analyzed.
Semen analysis was based on 2010 World Health Organization reference criteria. Each patient underwent semen culture test to identify common urogenital pathogens. Infections by Mycoplasma, Ureaplasma, and Chlamydia spp. were evaluated through a real time polymerase chain reaction platform. Descriptive statistics and linear and logistic regression models were used to test the association between semen infections and clinical, seminal, and hormonal parameters.
Prevalence of asymptomatic semen infection and impact of semen infection on sperm parameters.
Of 1689 men, 354 (21.0%) had an asymptomatic positive semen culture. Ureaplasma urealyticum (37.6%) was the most frequent single pathogen, followed by Enterobacteriaceae (any type; 24.8%), other pathogens (20.3%), Chlamydia trachomatis (3.4%) and Mycoplasma spp (3.4%). Positive semen cultures were associated with lower sperm concentrations (P<0.001) and progressive motility (P<.001). These latter findings were mostly particular to men with infections caused by Ureaplasma urealyticum compared with negative semen cultures. A positive semen culture was both univariably (P<.001) and multivariably (P=.04) associated with a lower sperm concentration.
One out of five men presenting for a couple's primary infertility had asymptomatic semen infections, which were significantly associated with impaired sperm concentration. These observations point out the importance of an accurate investigation of semen infection in the everyday clinical practice diagnostic workup of infertile men.
Fertility and sterility. 2020 Apr 13 [Epub ahead of print]
Luca Boeri, Filippo Pederzoli, Paolo Capogrosso, Costantino Abbate, Massimo Alfano, Nicasio Mancini, Massimo Clementi, Emanuele Montanari, Francesco Montorsi, Andrea Salonia
Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy., Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; Laboratory of Microbiology and Virology, IRCCS Ospedale San Raffaele, Milan, Italy., Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy., Laboratory of Microbiology and Virology, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy., Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy., Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy., Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy. Electronic address: .