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男性不育症:由性传播病原体引起的公共卫生问题。

Male infertility: a public health issue caused by sexually transmitted pathogens.

机构信息

Laboratory of Clinical Cytology and Semen Analysis, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, PR 87020900, Brazil.

Division of Semen Analysis, São Camilo Clinical Analysis Laboratory, Maringá, PR 87013050, Brazil.

出版信息

Nat Rev Urol. 2014 Dec;11(12):672-87. doi: 10.1038/nrurol.2014.285. Epub 2014 Oct 21.

Abstract

Sexually transmitted diseases (STDs) are caused by several pathogens, including bacteria, viruses and protozoa, and can induce male infertility through multiple pathophysiological mechanisms. Additionally, horizontal transmission of STD pathogens to sexual partners or vertical transmission to fetuses and neonates is possible. Chlamydia trachomatis, Ureaplasma spp., human papillomavirus, hepatitis B and hepatitis C viruses, HIV-1 and human cytomegalovirus have all been detected in semen from symptomatic and asymptomatic men with testicular, accessory gland and urethral infections. These pathogens are associated with poor sperm quality and decreased sperm concentration and motility. However, the effects of these STD agents on semen quality are unclear, as are the effects of herpes simplex virus type 1 and type 2, Neisseria gonorrhoeae, Mycoplasma spp., Treponema pallidum and Trichomonas vaginalis, because few studies have evaluated the influence of these pathogens on male infertility. Chronic or inadequately treated infections seem to be more relevant to infertility than acute infections are, although in many cases the exact aetiological agents remain unknown.

摘要

性传播疾病(STDs)由多种病原体引起,包括细菌、病毒和原生动物,可通过多种病理生理机制导致男性不育。此外,性传播疾病病原体可能会在性伴侣之间横向传播,或垂直传播给胎儿和新生儿。在有睾丸、附属腺体和尿道感染症状和无症状的男性的精液中,已经检测到沙眼衣原体、解脲支原体、人乳头瘤病毒、乙型和丙型肝炎病毒、HIV-1 和人巨细胞病毒。这些病原体与精子质量差、精子浓度和活力下降有关。然而,这些性传播疾病病原体对精液质量的影响尚不清楚,单纯疱疹病毒 1 型和 2 型、淋病奈瑟菌、支原体、苍白密螺旋体和阴道毛滴虫也是如此,因为很少有研究评估这些病原体对男性不育的影响。慢性或治疗不充分的感染似乎比急性感染与不育更相关,尽管在许多情况下确切的病因仍未知。

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