[Value of detecting pathogens in fertility disorders].

The present study was carried out on 1092 asymptomatic male patients suffering from unexplained infertility without any history or clinical signs of inflammatory diseases of the genital tract. Semen samples were cultured for mycoplasma. In 214 of the patients, we additionally performed bacteriological investigations on seminal fluid, smears from the glans penis or prepuce, and urine specimens. Semen analysis included the common ejaculate parameters. We found significantly elevated counts of mycoplasma in 13% of the semen samples examined; pathogenic isolation rates of bacteria were observed in 36%. Increased counts of various bacterial species associated with high numbers of mycoplasma seem to be one of the causative factors in male infertility. There was not observed any close relationship between the recovery of microorganism and poor semen quality, except for fructose and citrate. When follow-up investigations were carried out in untreated patients, the concentrations of mycoplasma and bacteria in the semen fluid revealed a spontaneous variability of considerable extent, indicating frequent contamination of the semen. Therefore, we recommend to perform a culture control test of the semen prior to specific antibiotic treatment.