Infection and inflammation of the seminal tract: A review of its relationship to male fertility.

INTRODUCTION

In 1997, the WHO established the role of genital tract infections in human infertility, currently responsible for 15% of the causes of infertility in men. The WHO classifies urethritis, prostatitis, vesiculitis, orchitis, and epididymitis as infections of the male accessory gland. This paper represents the state of the art on inflammation and infection of seminal tract. Objective of the study is to revise literature and to discuss regarding association to fertility.

METHODS

A literature search was performed on PubMed database (http://www.pubmed.gov) for peer-reviewed journal articles relating to STD, UTI, Diagnosis and Treatment and Fertility. We carefully evaluated the most representative reports published in literature and all papers results were supported by European and American guidelines results on theme.

RESULTS

Seminal tract infections may cause infertility by different mechanisms. Traditionally, the most common infectious causes of male infertility were sexually transmitted infections, especially Neisseria gonorrhoeae. However, the most frequent causes of infection of the seminal tract are Chlamydia trachomatis, Microplasma spp., especially Ureaplasma urealyticum and the gram-negative bacteria typical of urogenital infections. When classifying seminal tract infections, it must be considered whether or not these are sexually transmitted, and treat both partners for Sexual Transmitted Diesase if necessary (STI). There is evidence that treating STIs leads to improved semen parameters. Although antibiotics can improve sperm quality and reduce DNA fragmentation values, there is no evidence that they increase the probability of natural conception.

CONCLUSIONS

Taking into account the highly prevalence of infective or inflammatory affections of the male genital tract, its clearly stablished association with infertility and that a remarkable percentage of sexual transmitted infections (STI) are asymptomatic, we believe that these infections must be ruled out during the initial andrological evaluation in couples seeking fertility.