突尼斯的沙眼衣原体与男性不育症

Chlamydia trachomatis and male infertility in Tunisia.

作者信息

Gdoura R, Keskes-Ammar L, Bouzid F, Eb F, Hammami A, Orfila J

机构信息

Laboratory of Bacteriology-Virology, University School of Medicine Sfax, Tunisia.

出版信息

Eur J Contracept Reprod Health Care. 2001 Jun;6(2):102-7.

PMID:11518447

Abstract

OBJECTIVE

Chlamydia trachomatis is a common sexually transmitted micro-organism. The impact of chlamydial infection on semen parameters and male fertility is controversial. Our purpose was to determine the prevalence of C. trachomatis in the male partners of infertile couples in Tunisia and to assess the relationship between chlamydial infection markers and male infertility.

METHODS

Chlamydial DNA in urethral and in semen specimens was determined by using the Cobas Amplicor polymerase chain reaction (PCR) assay and chlamydial immunoglobulin G (IgG) antibodies were measured by micro-immunofluorescence in serum samples in 92 male partners, with or without pathological standard semen parameters, according to the guidelines of the World Health Organization (sperm count, progressive sperm motility, sperm morphology and sperm viability). In parallel, chlamydial infection markers in endocervical material were determined by PCR and chlamydial IgG antibodies were measured by micro-immunofluorescence in serum samples from the female partners of the patients.

RESULTS

C. trachomatis was found in 35.9% (33/92) of the male partners of the infertile couples and in 38% (35/92) of their female partners. There was a significant correlation between the detection of C. trachomatis in both partners (p = 0.004). C. trachomatis DNA was detected in 18.5% (17/92) of urethral specimens and in 16.3% (15/92) of semen specimens. Chlamydial IgG antibodies were present in 9.8% (9/92) of the serum samples. A standard semen analysis showed that 88% (81/92) were pathological. Sperm viability, progressive sperm motility, morphology and sperm concentration were abnormal in 73.8%, 70.2%, 34.5% and 13%, respectively, of the 92 evaluated semen specimens. Comparison of the parameters of the standard semen analysis between the male partners of the infertile couples with or without chlamydial infection markers showed that only the presence of C. trachomatis DNA in semen samples can affect sperm motility. Parameters of the standard semen analysis were not significantly related either to the detection of chlamydial DNA in urethral samples or to the presence of serum chlamydial antibodies.

CONCLUSION

Our results show that C. trachomatis seems to be widespread among the male partners of infertile couples in Tunisia and show that this organism can affect sperm motility and, thus, can play an important role in the etiology of male infertility.

摘要

目的

沙眼衣原体是一种常见的性传播微生物。衣原体感染对精液参数和男性生育能力的影响存在争议。我们的目的是确定突尼斯不育夫妇男性伴侣中沙眼衣原体的患病率，并评估衣原体感染标志物与男性不育之间的关系。

方法

根据世界卫生组织的指南（精子数量、精子前向运动能力、精子形态和精子活力），使用Cobas Amplicor聚合酶链反应（PCR）检测法测定92名男性伴侣尿道和精液标本中的衣原体DNA，并通过微量免疫荧光法检测血清样本中的衣原体免疫球蛋白G（IgG）抗体，这些男性伴侣的精液参数有无病理改变。同时，通过PCR测定宫颈材料中的衣原体感染标志物，并通过微量免疫荧光法检测患者女性伴侣血清样本中的衣原体IgG抗体。

结果

不育夫妇中35.9%（33/92）的男性伴侣和38%（35/92）的女性伴侣检测出沙眼衣原体。双方检测出沙眼衣原体之间存在显著相关性（p = 0.004）。在18.5%（17/92）的尿道标本和16.3%（15/92）的精液标本中检测到沙眼衣原体DNA。9.8%（9/92）的血清样本中存在衣原体IgG抗体。标准精液分析显示88%（81/92）存在病理改变。在92份评估的精液标本中，精子活力、精子前向运动能力、形态和精子浓度异常的分别占73.8%、70.2%、34.5%和13%。比较有无衣原体感染标志物的不育夫妇男性伴侣的标准精液分析参数，发现只有精液样本中存在沙眼衣原体DNA会影响精子运动能力。标准精液分析参数与尿道样本中衣原体DNA的检测或血清衣原体抗体的存在均无显著相关性。