Gdoura R, Daoudi F, Bouzid F, Ben Salah F, Chaigneau C, Sueur J M, Eb F, Rekik S, Hammami A, Orfila J
Laboratory of Bacteriology-Virology, University School of Medicine, Sfax, Tunisia.
Eur J Contracept Reprod Health Care. 2001 Mar;6(1):14-20.
The sequelae to infection with Chlamydia trachomatis in women are an established cause of tubal infertility. However, little is known about chlamydial infection and male infertility. The main objective of this study was to evaluate the presence of asymptomatic C. trachomatis infections in urethral and semen specimens from the male members of infertile couples by means of four different methods: the direct fluorescence antibodies assay, cell culture, the Roche Cobas Amplicor polymerase chain reaction, and the presence of chlamydial local IgA antibodies by the recombinant antibody-enzyme-linked immunosorbent assay. One or more chlamydial infection markers were detected in 42 (45.7%) of the 92 examined urethral and semen specimens from the male partners of infertile couples. C. trachomatis was detected in 23.9% (22/92) of urethral specimens and in 35.9% (33/92) of semen specimens. Although there was a significant correlation between the detection of one or more chlamydial infection markers in urethral and semen specimens (p = 0.01), no significant correlation was found between the detection of C. trachomatis DNA in these samples. Furthermore, no significant association was found between the presence of chlamydial local IgA antibodies and the detection of C. trachomatis. The discrepancies in positive results found between some techniques for the detection of C. trachomatis in urethral and semen specimens might be explained by variations in the sensitivities and specificities of the tests carried out and the use of specimens from different anatomical locations. Our findings suggest that C. trachomatis seems to be widespread among the male partners of infertile couples in Tunisia. The detection of C. trachomatis in urethral or semen specimens can serve as a marker for the presence of this organism in the genital tract, which is not necessarily the cause of male infertility. The study of the correlation between the detection of chlamydial infection markers and the parameters of male fertility seems to be necessary in order to determine the direct link between chlamydial infection and male infertility and to choose the most efficient technique and most suitable specimen with which to diagnose C. trachomatis-associated male infertility.
沙眼衣原体感染对女性造成的后遗症是输卵管性不孕的既定病因。然而，人们对衣原体感染与男性不育知之甚少。本研究的主要目的是通过四种不同方法评估不育夫妇男性成员尿道和精液标本中无症状沙眼衣原体感染的情况：直接荧光抗体检测法、细胞培养法、罗氏Cobas Amplicor聚合酶链反应法以及通过重组抗体 - 酶联免疫吸附测定法检测衣原体局部IgA抗体。在92份来自不育夫妇男性伴侣的尿道和精液检测标本中，有42份（45.7%）检测到一种或多种衣原体感染标志物。在23.9%（22/92）的尿道标本和35.9%（33/92）的精液标本中检测到沙眼衣原体。虽然在尿道和精液标本中检测到一种或多种衣原体感染标志物之间存在显著相关性（p = 0.01），但在这些样本中沙眼衣原体DNA的检测之间未发现显著相关性。此外，衣原体局部IgA抗体的存在与沙眼衣原体的检测之间也未发现显著关联。尿道和精液标本中沙眼衣原体检测的某些技术之间阳性结果的差异，可能是由于所进行检测的敏感性和特异性不同以及使用了来自不同解剖部位的标本所致。我们的研究结果表明，沙眼衣原体似乎在突尼斯不育夫妇的男性伴侣中广泛存在。在尿道或精液标本中检测到沙眼衣原体可作为该生物体在生殖道中存在的标志物，但不一定是男性不育的原因。为了确定衣原体感染与男性不育之间的直接联系，并选择最有效的技术和最合适的标本以诊断与沙眼衣原体相关的男性不育，研究衣原体感染标志物检测与男性生育参数之间的相关性似乎很有必要。
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