Schistosomiasis: a neglected cause of infertility in females and males.

PURPOSE OF REVIEW: Schistosomiasis affects over 250 million individuals worldwide and has been associated with infertility, which can harm the mental, physical, and social well being of individuals. This review aims to summarize the multiple ways in which schistosome infection can affect fertility in females and males, through functional, hormonal, and systemic processes.

RECENT FINDINGS: Schistosome infection causes functional genital tract damage through granuloma formation and fibrosis, which can lead to organ damage and obstruction in the male and female genital tracts. Hormone imbalances caused by the release of estrogen-like metabolites by schistosome worms can dysregulate the hypothalamic-pituitary-gonadal axis and disturb the menstrual cycle, ovulation, and male reproductive function. Systemic and local tissue immunologic changes in response to schistosomes may lower sperm and semen quality, hinder implantation in the uterus, or contribute to early spontaneous abortions.

SUMMARY: Via an array of mechanisms, schistosome infections can impair both female and male fertility. Studies in this neglected area are limited, and further investigation into disease processes and potential therapies for both females and males are greatly needed.