Department of Life Science and Bioinformatics, Assam University, Silchar, India.
Department of Microbiology, R. G. Kar Medical College and Hospital, Kolkata, India.
Adv Exp Med Biol. 2022;1358:115-140. doi: 10.1007/978-3-030-89340-8_6.
Male infertility is considered as a multifactorial complex reproductive illness, and male urogenital infection and inflammation are crucial etiologies contributing up to 35% of all cases. Mostly triggered by sexually transmitted diseases and uropathogens, chronic manifestation of such infection may cause irreversible infertility in the male. Male urogenital infection involves bacterial, viral, protozoal, and fungal infections many of which remain asymptomatic most of the time and are passed to the sexual partner leading to fertilization failure, pregnancy loss, and even development of illness in the offspring. The abundance of leukocytes in semen can be used as an indicator of urogenital infection. Its contribution in male infertility can be as high as 30% and the clinical condition is referred to as leukocytospermia. Seminal bacterial load together with increased leukocytes contribute to the impairment of male fertility parameters such as, sperm motility, DNA integrity, acrosome reaction, and damage sperm molecular structure. Pathophysiology of bacteriospermia-induced impairment of male infertility is probably mediated by the involvement of bacterial pathogens in the intrinsic apoptotic pathway resulting in sperm death, whereas that of seminal leukocytes operates through excessive generation of ROS. Although the application of antibiotics forms the frontline therapeutic approach, the growing resistance to antibiotics poses a concern in the management of microbes-induced male urogenital infection. Complementary and alternative medicine may offer additional management options in combating such infections. On the other hand, both broad spectrum antibiotics and antioxidant therapy have showed promising results in the management of infertile men with leukocytospermia. Use of herbal medicine may also play a promising role in the management of such patients. However, recent molecular biology techniques have noted the association of elevated levels of IL-8 with both the Chlamydial infection of the male urogenital tract as well as the clinical condition of leukocytospermia. On the basis of such common pathogenesis, further research involving advanced molecular techniques may pave the way towards the development of better diagnostic tools in the clinical management of male urogenital infection and leukocytospermia.
男性不育被认为是一种多因素复杂的生殖疾病，男性泌尿生殖系统感染和炎症是导致 35%病例的关键病因。这些感染主要由性传播疾病和尿路病原体引起，慢性表现可能导致男性不育的不可逆转。男性泌尿生殖系统感染包括细菌、病毒、原生动物和真菌感染，其中许多在大多数时候无症状，并传染给性伴侣，导致受精失败、妊娠丢失，甚至后代发病。精液中白细胞的数量可以作为泌尿生殖系统感染的指标。其对男性不育的贡献高达 30%，临床状况称为白细胞精子症。精液细菌负荷量和白细胞增多都会损害男性生育参数，如精子活力、DNA 完整性、顶体反应和精子分子结构损伤。细菌性精子症引起男性不育的病理生理学可能是由细菌病原体参与内在凋亡途径导致精子死亡引起的，而精液白细胞则通过过度产生 ROS 起作用。虽然抗生素的应用构成了一线治疗方法，但抗生素耐药性的增加对微生物引起的男性泌尿生殖系统感染的管理构成了担忧。补充和替代医学可能为对抗此类感染提供额外的管理选择。另一方面，广谱抗生素和抗氧化治疗在白细胞精子症不育男性的管理中显示出有希望的结果。草药的使用也可能在这些患者的管理中发挥有前途的作用。然而，最近的分子生物学技术已经注意到白细胞介素-8 水平升高与男性泌尿生殖系统沙眼衣原体感染以及白细胞精子症的临床状况有关。基于这种共同的发病机制，涉及先进分子技术的进一步研究可能为男性泌尿生殖系统感染和白细胞精子症的临床管理开发更好的诊断工具铺平道路。
