Chlamydia Trachomatis in Men with Impaired Fertility

Overview

Objective:
The objective of the prospective study was to assess whether there exists a relationshipbetween the results of positive laboratory tests for the presence of Chlamydia infection (asses-sment of the presence of Chlamydia trachomatis in the ejaculate by the DNA amplification met-hod, IgA and IgG antichlamydia antibodies in the ejaculate and serum), an abnormalspermiogram and total number of sexual partners in men from infertile couples examined at theGynaecological and Obstetric Clinic of the First Medical Faculty, Charles University Prague.Design: Prospective clinical study.Setting: Department of Gynaec.-Obstet., the 1 st Medical Faculty of the Charles University, Prague,Czech Republic - Institut of Clinical Biochemy, the 1 st Medical Faculty of Charles University,Prague, Czech Republic.Method: 101 men were examined. In all the spermiogram was evaluated according to WHO crite-ria. Specific antichlamydial antibodies IgA and IgG in serum and the ejaculate were assessed bythe ELISA method. Evidence of the DNA portion of Chlamydia trachomatis was provided by theMEIA method. Amplification of DNA by LCR was made on a Thermocycler. By means of an aimedquestionnaire the number of all sexual partners was assessed. The men were divided into threegroups with 1-5, 6-9 and with 10 or more partners. Patients where Chlamydia infection wasdetected were treated with Ig Azitromycin and their spermiogram was checked 6-8 weeks aftertreatment.The results of the examination were tested by the chi square test.Results: An abnormal spermiogram was found in 44 (44%) of the examined subjects. With theincreasing number of sexual partners the number of men with pathospermia increased. In noneLCR for the presence of Chlamydia trachomatis was positive in the ejaculate. In 15 examinedpatients IgA antichlamydia antibodies were found in the ejaculate. At the same time in all anabnormal spermiogram was found and 11 (73%) of them had six or more sexual partners. Aftertreatment in 8 (62%) of 13 (two did not attend the check-up) marked improvement of the spermio-gram occurred.Conclusion: IgA antichlamydial antibodies in the ejaculate proved in 62% of the examined menwith an abnormal spermiogram a useful indicator of infection in the genital tract. With theincreasing number of sexual partners the number of pathospermias increased.

Key words:
male infertility, Chlamydia trachomatis, abnormal spermiogram