Several previous studies have reported the role of Chlamydia trachomatis in causing urethritis and cervicitis, and the associated sequelae, including pelvic inflammatory disease (PID), tubal factor infertility, and ectopic pregnancy. However, there are contradictory results regarding the detrimental effects of infection on seminal parameters and male fertility. Now, a study published in the journal Fertility and Sterility reports an enhanced prevalence of plasma immunoglobulin G (IgG) antibodies to C trachomatis in the male partners of infertile couples.
Paivi Joki-Korpela, from the Department of Obstetrics and Gynecology, University of Helsinki, Finland, and colleagues, evaluated the association between Chlamydia trachomatis infection and infertility in 90 infertile subjects who visited a university hospital IVF clinic for IVF/intracytoplasmic sperm injection (ICSI). The control group comprised of 190 healthy blood donors who were evaluated for the presence of IgG and IgA antibodies to C trachomatis. Semen analysis was carried out in the patients from the study group. The results showed an increased prevalence of chlamydia-specific IgG antibodies in infertile subjects compared to controls, and also lower sperm counts in men with chlamydial antibodies.
A similar study, conducted by Gdoura, et al. (European Journal of Contraception and Reproductive Health Care, 2001) assessed the prevalence of C trachomatis in the male partners of infertile couples in Tunisia and also the association between chlamydial infection markers and male infertility. The researchers used Cobas Amplicor polymerase chain reaction (PCR) assay to determine chlamydial DNA in urethral and semen specimens and micro-immunofluorescence to evaluate chlamydial IgG antibodies in the serum samples of 92 subjects with or without abnormal semen parameters. Also, the researchers parallelly assessed chlamydial infection markers in endocervical specimens and chlamydial IgG antibodies in serum samples obtained from the female partners of the study subjects. The following findings were reported:
• Presence of C trachomatis in 35.9% of male subjects and 38% of their female partners
• C trachomatis DNA in18.5% of urethral specimens and 16.3% of semen specimens
• Chlamydial IgG antibodies in 9.8% of the studied serum samples
• Standard semen analysis identified 88% of the semen samples as pathological
• Abnormalities in sperm viability, sperm morphology, progressive sperm motility and sperm concentration were observed in 73.8%, 34.5%, 70.2%, and 13%, respectively, of semen samples collected from male partners of infertile couples.
The results showed an increased prevalence of C trachomatis infection among the male partners of infertile couples. Also, the findings revealed the detrimental effect of the infection on sperm motility, thereby suggesting its role in the etiology of male infertility.
Previous studies have also reported that male chlamydial infection could have an adverse effect on the fertility of their female partners. As the infection may contribute to abnormal sperm parameters, DNA fragmentation, and impaired acrosome reaction capacity, it has been thought to have a direct effect in damaging the sperm, thereby affecting male fertility. The study results indicating increased occurrence of plasma IgG antibodies to C trachomatis in infertile subjects could pave the way for developing novel strategies for the treatment of male infertility associated with infection. Also, the study underscores the need for safe-sex practices to prevent the spread of infection.
1. Joki-Korpela P, Sahrakorpi N, Halttunen M, Surcel HM, Paavonen J, Tiitinen A. The role of Chlamydia trachomatis infection in male infertility. Fertil Steril. 2009 Apr;91(4 Suppl):1448-50.
2. Gdoura R, Keskes-Ammar L, Bouzid F, Eb F, Hammami A, Orfila J. Chlamydia trachomatis and male infertility in Tunisia. Eur J Contracept Reprod Health Care. 2001 Jun;6(2):102-7.