Gholami Mehrdad, Moosazadeh Mahmood, Haghshenash Mohammad Reza, Jafarpour Hamed, Mousavi Tahoora
Department of Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Molecular and Cell Biology Research Center (MCBRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran.
Front Med (Lausanne). 2022 May 4;9:835254. doi: 10.3389/fmed.2022.835254. eCollection 2022.
OBJECTIVES: Infections in the male genitourinary system with bacterial and viral agents may play a significant role in male infertility. These agents usually infect the urethra, seminal vesicles, prostate, epididymis, vas deferens, and testes retrograde through the reproductive system. A meta-analysis review study was performed to evaluate the presence of bacterial and viral agents in the semen of infertile men and its correlation with infertility. METHODS: Relevant cross-sectional and/or case-control studies were found by an online review of national and international databases (Web of Science, PubMed, Scopus, Science Direct, and Google scholar), and suitable studies were selected. A checklist determined the qualities of all studies. Heterogeneity assay among the primary studies was evaluated by Cochran's test and I index (significance level 50%). A statistical analysis was conducted using the Comprehensive Stata ver. 14 package (StataCorp, College Station, TX, United States). RESULTS: Seventy-two studies were included in this meta-analysis. Publication bias was compared with Egger's test, and the impact of each research on overall estimate was evaluated by sensitivity analysis. In 56 studies, the rate of bacterial infections in the semen of infertile men was 12% [95% confidence interval (CI): 10-13]. Also, in 26 case-control studies, the association of infertility in men with bacterial infections was evaluated. The results show that the odds ratio of infertility in men exposed to bacterial infections is 3.31 times higher than that in non-infected men (95% CI: 2.60-4.23). Besides, in 9 studies that examined the prevalence of human papillomavirus (HPV), herpes simplex virus 1 (HSV1), herpes simplex virus 2 (HSV2), and herpes simplex virus 1-2 (HSV1-2) in infertile men, the frequency of these viruses was 15% (95% CI: 9-21). In 6 case-control studies, the association between human cytomegalovirus (HCMV), Cytomegalovirus (CMV), and HPV and male infertility was evaluated. The chance of male infertility due to exposure to these viruses was 2.24 times higher than those without exposure to these viruses (CI 95%: 1.9-4.52). The results show that the chance of infertility in men exposed to bacteria was significantly higher than that in the uninfected population. CONCLUSION: This meta-analysis showed that viral and bacterial infections are a risk factor and could impair male fertility potential. Moreover, our study supports the hypothesis that bacterial and viral infections of the genital tract correlate positively with impairment of sperm quality in the male population.
目的:男性生殖泌尿系统的细菌和病毒感染可能在男性不育中起重要作用。这些病原体通常通过生殖系统逆行感染尿道、精囊、前列腺、附睾、输精管和睾丸。进行了一项荟萃分析综述研究,以评估不育男性精液中细菌和病毒病原体的存在及其与不育的相关性。 方法:通过对国内和国际数据库(科学网、PubMed、Scopus、科学Direct和谷歌学术)进行在线检索,找到相关的横断面和/或病例对照研究,并选择合适的研究。一份清单确定了所有研究的质量。通过 Cochr an检验和I指数(显著性水平50%)评估主要研究之间的异质性。使用综合Stata 14版本软件包(美国德克萨斯州大学站StataCorp公司)进行统计分析。 结果:本荟萃分析纳入了72项研究。用Egger检验比较发表偏倚,并通过敏感性分析评估每项研究对总体估计的影响。在56项研究中,不育男性精液中的细菌感染率为12%[95%置信区间(CI):10 - 13]。此外,在2项病例对照研究中,评估了男性不育与细菌感染的关联。结果显示,暴露于细菌感染的男性不育的优势比是非感染男性的3.31倍(95%CI:2.60 - 4.23)。此外,在9项检测不育男性人乳头瘤病毒(HPV)、单纯疱疹病毒1型(HSV1)、单纯疱疹病毒2型(HSV2)和单纯疱疹病毒1 - 2型(HSV1 - 2)患病率的研究中,这些病毒的感染率为15%(95%CI:9 - 21)。在6项病例对照研究中,评估了人巨细胞病毒(HCMV)、巨细胞病毒(CMV)和HPV与男性不育之间的关联。暴露于这些病毒导致男性不育的几率比未暴露于这些病毒的人高2.24倍(95%CI:1.9 - 4.52)。结果表明,暴露于细菌的男性不育几率显著高于未感染人群。 结论:本荟萃分析表明,病毒和细菌感染是一个危险因素,可能损害男性生育潜力。此外,我们的研究支持这样的假设,即生殖道的细菌和病毒感染与男性人群精子质量受损呈正相关。
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