Greendale G A, Haas S T, Holbrook K, Walsh B, Schachter J, Phillips R S
Division of General Internal Medicine and Health Services Research, University of California-Los Angeles School of Medicine.
Am J Public Health. 1993 Jul;83(7):996-1001. doi: 10.2105/ajph.83.7.996.
Infertility affects at least 2 million couples in the United States. One third of infertility is attributed to male causes, but the etiology of most male infertility remains obscure. This study was designed to investigate the relationship between Chlamydia trachomatis and unexplained infertility in men.
Questionnaires and serum were collected prospectively from 52 case subjects (men from couples with explicitly defined idiopathic infertility) and 79 control subjects (first-time expectant fathers).
Case subjects were significantly more likely than control subjects to be seropositive for antibody to C trachomatis at a titer of 1:64 or higher. By test of trend, higher titers were associated with higher odds ratios. Adjustment for age of either partner at initiation of pregnancy attempt, race, income, previous genitourinary symptoms or diagnoses, number of previous sexual partners, and barrier contraceptive use had no significant effect on the estimate of the odds ratio. One half of the men who were antibody positive had no history of genitourinary symptoms.
Our results suggest an association between infection with C trachomatis in men and unexplained infertility and imply that infection is frequently asymptomatic.
在美国，不孕症影响着至少200万对夫妇。三分之一的不孕症归因于男性因素，但大多数男性不育症的病因仍不清楚。本研究旨在调查沙眼衣原体与男性不明原因不孕症之间的关系。
前瞻性收集了52例受试者（来自明确诊断为特发性不孕症夫妇的男性）和79例对照受试者（初为准父亲者）的问卷和血清。
病例组受试者沙眼衣原体抗体滴度为1:64或更高时血清阳性的可能性显著高于对照组受试者。通过趋势检验，滴度越高，比值比越高。对怀孕尝试开始时任何一方的年龄、种族、收入、既往泌尿生殖系统症状或诊断、既往性伴侣数量以及屏障避孕措施的使用进行调整，对比值比的估计没有显著影响。抗体阳性的男性中有一半没有泌尿生殖系统症状史。
我们的结果表明男性感染沙眼衣原体与不明原因不孕症之间存在关联，并暗示感染通常无症状。
