Abstract
Genitourinary tract infections and other inflammatory conditions are known contributors to male-factor infertility.1,2 Their effects are still not entirely understood, but there are strong associations. Because male-factor infertility accounts for 30% to 50% of infertility cases,3 and genitourinary infections are ubiquitous, these associations are of great interest. Because these infections are both preventable and treatable, much study has been done in this field. Unfortunately, there is a paucity of confirmatory data on the etiology of the process and treatment efficacy. The difficulty in most of the research on the association between infection and infertility has been in proving the presence of a causal agent. Thus, it is problematic to assess the efficacy of any given treatment modality. In females, there is little doubt that early, aggressive antibiotic therapy is beneficial in preventing secondary tubular damage due to pelvic inflammatory disease.4 Furthermore, localized infections in the vagina are known to limit fertility, and aggressive, curative treatment is beneficial to fertility rates.5 The low incidence of symptoms and physical findings in the male proves to be daunting in the evaluation of treatment. When there is an absence of a proven causative organism, the results of any treatment may not be evaluable. When the final common pathway is pregnancy and the semen analysis is usually not definitive, one may be dealing simply with probabilities. It may be best to divide this discussion into infections versus noninfections; however, the line between these two is frequently indistinct.
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References
Hellstrom WJG, Neal DE Jr. Diagnosis and therapy of male genital tract infections. Infertil Reprod Med Clin North Am 1992; 3: 399–411.
Bar-Chama N, Goluboff E, Fisch H. Infection and pyosphermia in male infertility. Is it really a problem? Urol Clin North Am 1994; 21: 469–475.
Lipshultz LI, Howards SS. Evaluation of the subfertile man. Semin Urol 1984; 2: 73.
Paavonen J. Chlamydia trachomatis in acute salpingitis. Am J Obstet Gynecol 1980; 138: 957–960.
Rosenthal L. Spermagglutination by bacteria. Proc Soc Exp Biol Med 1977; 28: 827–821.
Bowie WR. Nongonococcal urethritis. Urol Clin North Am 1984; 11: 55–64.
Harnisch JP, Berger RE, Alexander ER. Etiology of acute epididymitis. Lancet 1977; 1: 819–821.
Berger RE, Alexander ER, Harnisch JP, et al. Etiology, manifestations and therapy of acute epididymitis: prospective study of 50 cases. J Urol 1979; 121: 750–754.
Handsfield HH, Lipman TO, Harnisch JB, et al. Asymptomatic gonorrhea in men: diagnosis, natural course, prevalence and significance. N Engl J Med 1974; 290: 117–122.
Neal DE Jr, Dilworth JP, Kaack MB, et al. Experimental prostatitis in nonhuman primates: II. Ascending acute prostatitis. Prostate 1990; 17: 233–239.
Nickel JC, Olson ME, Costerton JW. Rat model of experimental bacterial prostatitis. Infection 1991; 19: S126–130.
Blacklock NJ. The significance of the prostate in urinary tract infection in the male. J R Naval Med Ser 1970; 56: 5–17.
Meacham RB, Hellerstein DK, Lipshultz LI. Evaluation and treatment of ejaculatory duct obstruction in the infertile male. Fertil Steril 1993; 59: 393–397.
Weintraub MP, Demouy E, Hellstrom WJ. Newer modalities in the diagnosis and treatment of ejaculatory duct obstruction. J Urol 1993; 150: 1150–1154.
Neal DE Jr, Kaack MB, Fussell EN, et al. Changes in seminal fluid zinc during experimental prostatitis. Urol Res 1993; 21: 71–74.
Gowan LA, Barsanti JA, Brown J, et al. Effects of bacterial infection and castration on prostatic tissue zinc concentration in dogs. Am J Vet Res 1991; 52: 1262–1265.
Krongrad A, Droller MJ. Zinc and the prostate. In: Paulson DF, ed. Prostatic disorders. Philadelphia: Lea and Febiger; 1989: 107–112.
Marmar JL, Katz S, Praiss DE, et al. Semen zinc levels in infertile and post-vasectomy patients and patients with prostatitis. Fertil Steril 1975; 26: 1057–1060.
Gyorkey F, Min KW, Huff JA, et al. Zinc and magnesium in human prostate gland: normal, hyperplastic, and neoplastic. Cancer Res 1967; 27: 1348–1352.
Fair WR, Couch J, Wehner N. Prostate antibacterial factor. Urology 1976; 7: 169–173.
Monga M, Roberts JA. Sperm agglutination by bacteria: receptor-specific interactions. J Androl 1994; 15: 151–156.
Fowler JE Jr. Infections of the male reproductive tract and infertility: a selected review. J Androl 1981; 3: 121.
Roberts JA. Role of bacterial adherence in urinary tract infection. Curr Opin Urol 1992; 2: 33–36.
Cohen J, Edwards R, Fehilly C, et al. In vitro fertilization: a treatment for male infertility. Fertil Steril 1985; 43: 422–432.
Hill JA, Cohen J, Anderson DJ. The effects of lymphokines and monokines on sperm fertilizing ability in the zona-free hamster egg penetration test. Am J Obstet Gynecol 1989; 160: 1154–1163.
Hellstrom WJG, Schacter J, Sweet RL, et al. Is there a role for Chlamydia trachomatis and genital mycoplasma in male infertility? Fertil Steril 1987; 48: 337.
Friberg J. Mycoplasmas and Ureaplasmas in infertility and abortion. Fertil Steril 1980; 33: 351–359.
Harrison RG, DeLouvois J, Sweet RL. Is there a role for Chlamydia trachomatis and genital mycoplasma in male infertility? Lancet 1975; 1: 605–607.
Greendale GA, Haas ST, Holbrook K, et al. The relationship of Chlamydia trachomatis infection and male infertility. Am J Public Health 1993; 83: 996–1001.
Moskowitz MO, Meilinger BC. Sexually transmitted diseases and their relation to male infertility. Urol Clin North Am 1992; 19: 35–44.
Wolff H, Neubert U, Zebhauser M, et al. Chlamydia trachomatis induces an inflammatory response in the male genital tract and is associated with altered semen quality. Fertil Steril 1991; 55: 1017–1019.
Karam GH, Martin DH, Flotte TR, et al. Asymptomatic Chlamydia trachomatis infections among sexually active men. J Infect Dis 1986; 154: 900–903.
Drach GW. Problems in diagnosis of bacterial prostatitis: gram-negative, gram-positive and mixed infections./Urol 1974; 111: 630.
Fowlkes DM, MacLeod J, O’Leary WM. T- mycoplasmas and human infertility: correlation of infection with alterations in seminal parameters. Fertil Steril 1975; 26: 1212–1218.
Swenson CE, Toth A, O’Leary WM. Urea-plasma urealyticum and human infertility: the effect of antibiotic therapy on semen quality. Fertil Steril 1979; 31: 660–665.
Busolo F, Zanchetta R. The effect of Mycoplasma hominis and Ureaplasma urealyticum on hamster egg in vitro penetration by human spermatozoa. Fertil Steril 1985; 43: 110–114.
Toth A, Lesser ML, Brooks C, et al. Subsequent pregnancies among 161 couples treated for T- mycoplasma genital tract infection. N Engl J Med 1983; 308: 505–507.
Riggs S, Sanford JP. Viral orchitis. N Engl J Med 1962; 266: 990–993.
Litvin YS, Nagler H. Infertility and genitourinary infections. Infect Urol 1992; 5:104– 107.
Taub RG, Madden DL, Fuccillo DA, et al. The male as a reservoir of infection with cytomegalovirus, herpes and mycoplasma. N Engl J Med 1973; 289: 697–698.
Krieger JN, Coombs RW, Collier AC, et al. Fertility parameters in men infected with human immunodeficiency virus. J Infect Dis 1991; 164: 464–469.
Curran JW. The epidemiology and prevention of the acquired immunodeficiency syndrome. Ann Intern Med 1985; 103: 657–662.
Mayer KH, Anderson DJ. Issue of the day. Heterosexual HIV transmission. Infect Agents Dis 1995; 4: 273–284.
Holmes KK, Handsfield HH, Nang SP, et al. Etiology of nongonococcal urethritis. N Engl J Med 1975; 292: 1199–1205.
Tuttle JF Jr, Holbrook TW, Derrick FC. Interference of human spermatozoal motility by Trichomonas vaginalis. J Urol 1977; 118: 1024–1025.
Gow JG, Barbosa S. Genitourinary tuberculosis. A study of 1117 cases over a period of 34 years. Br J Urol 1984; 56: 449–455.
Tuttle JF Jr, Bannister ER, Derrick FC. Interference of human spermatozoa agglutination by Candida albicans. J Urol 1977; 118: 797–799.
Wise GJ, Silver DA. Fungal infections of the genitourinary system. J Urol 1993; 149: 1377–1388.
Meares EM Jr, Stamey TA. Bacteriologic localization in bacterial prostatitis and urethritis. Invest Urol 1968; 5: 492–503.
Mobley DF. Semen cultures in the diagnosis of bacterial prostatitis. J Urol 1975; 114: 83–85.
Lowentritt JE, Kawahara K, Human LG, et al. Bacterial infection in prostatodynia. J Urol 1995; 154: 1378–1382.
Morton RS. White cell counts in human semen. Br J Vener Dis 1968; 44: 72–83.
Krieger JN. New sexually transmitted diseases treatment guidelines. J Urol 154: 209–214.
Hellstrom WJG, Schmidt RA, Lue TF, et al. Neuromuscular dysfunction in nonbacterial prostatitis. Urology 1987; 10: 183–188.
Neal DE Jr, Moon TD. Use of terazosin in prostatodynia and validation of a symptom score questionnaire. Urology 1994; 43: 460–465.
Crotty KL, May R, Kulvicki A, et al. The effect of antimicrobial therapy on testicular aspirate flow cytometry. J Urol 1995; 153: 835–838.
Schlegel PN, Chang TS, Marshall FF. Antibiotics: potential hazards to male infertility. Fertil Steril 1991; 55: 235–242.
Quesada EM, Dukes CD, Deen CH, et al. Genital infection and sperm agglutinating antibodies in infertile men. J Urol 1968; 99: 106–108.
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Neal, D.E. (1997). Infections and Infertility. In: Hellstrom, W.J.G. (eds) Male Infertility and Sexual Dysfunction. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1848-7_19
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DOI: https://doi.org/10.1007/978-1-4612-1848-7_19
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