ur Experience withExamination and Treatment of Men with Abnormal Spermiogram

Overview

Objective of study:
The objective of the prospective study was to assess whether there is a correlation between the results of positive laboratory tests for the presence of Chlamydia infection(assessment of Chlamydia trachomatis in the ejaculate by the DNA amplification method, IgA andIgG antichlamydia antibodies in the ejaculate and blood serum), an abnormal spermiogram andthe total number of sexual partners in men from infertile couples and the success of therapy.Method: 250 men were examined. In all the spermiogram was evaluated according to WHO criteria. Specific antichlamydia IgA and IgG antibodies in serum and ejaculate were assessed by theELISA method. Detection of a DNA segment of Chlamydia trachomatis was implemented by theMEIA method. Amplification of DNA by means of LCR was done on a Thermocycler. Using anaimed questionnaire the number of all sexual partners was assessed. The men were divided intothree groups: with 1 sexual partner, with 2-5 and 6 or more partners. The patients where a Chla-mydia infection was detected were treated with Ig azitromycin and their spermiogram was checked 8 weeks after treatment.Results: An abnormal spermiogram before treatment was found in 118 (47 %) of the examinedmen. With the rising number of sexual partners increased the number of men with pathospermia.Only in 2 (1%) of the examined men Chlamydia trachomatis was detected in the ejaculate. In 35 ofthe examined men IgA antichlamydia antibodies were detected in the ejaculate and concurrentlyan abnormal spermiogram was found. These men had a significantly higher number of sexualpartners than those who did not have IgA antibodies in the ejaculate. After treatment the spermiogram improved to normospermia in 18 of 30 (60%) men with pathospermia (5 men did not attendtreatment).Conclusion: Assessment of antichlamydia antibodies in the ejaculate proved useful in 60% of thesubjects with an abnormal spermiogram as an indicator of the presence of infection caused byChlamydia trachomatis in the male genital tract.

Key words:
male infertility, Chlamydia trachomatis, abnormal spermiogram, antichlamydia anti-bodies, DNA amplification