The Impact of Bacteriospermia on Semen Parameters: A Meta-Analysis
AbstractObjective: To evaluate the impact of bacteriospermia on semen parameters.Materials and methods: We used the Medline (1966-2017), Scopus (2004-2017), Clinicaltrials.gov (2008-2017), EMBASE, (1980-2017), LILACS (1985-2017) and Cochrane Central Register of Controlled Trials CENTRAL (1999-2017) databases in our primary search along with the reference lists of electronically retrieved full-text papers. Meta-analysis was performed with the RevMan 5.3 software.Results: Eighteen studies were finally included. Men were stratified in two groups, healthy controls (5,797 men) and those suffering from bacteriospermia (3,986 men). Total sperm volume was not affected by the presence of bacteriospermia when all pathogens were analyzed together (MD 0.02 95%CI -0.13,0.17). Both sperm concentration (MD -27.06, 95% CI -36.03, -18.08) and total sperm count (MD -15.12, 95% CI -21.08, -9.16) were significantly affected by bacteriospermia. Decreased rates of normal sperm morphology were also found (MD -5.43%, 95% CI -6.42, -4.44). The percentage of alive sperm was significantly affected by bacteriospermia (MD -4.39 %, 95% CI -8.25, -0.53). Total motility was also affected by bacteriospermia (MD -3.64, 95% CI -6.45, -0.84). In addition to this, progressive motility was significantly affected (MD -12.81, 95% CI -18.09, -7.53). Last but not least, pH was importantly affected (MD 0.03, 95% Cl 0.01, 0.04).Conclusion: Bacteriospermia significantly affects semen parameters and should be taken in mind even when asymptomatic. Further studies should evaluate the impact of antibiotic treatment on semen parameters and provide evidence on fertility outcome.
Rusz A, Pilatz A, Wagenlehner F, et al. Influence of urogenital infections and inflammation on semen quality and male fertility. World J Urol. 2012;30:23-30.
Diemer T, Huwe P, Ludwig M, et al. Urogenital infection and sperm motility. Andrologia. 2003;35:283-287.
Swenson CE, Toth A, Toth C, et al. Asymptomatic bacteriospermia in infertile men. Andrologia. 1980;12:7-11.
Domes T, Lo KC, Grober ED, et al. The incidence and effect of bacteriospermia and elevated seminal leukocytes on semen parameters. Fertil Steril. 2012;97:1050-1055.
Boitrelle F, Robin G, Lefebvre C, et al. [Bacteriospermia in Assisted Reproductive Techniques: effects of bacteria on spermatozoa and seminal plasma, diagnosis and treatment]. Gynecol Obstet Fertil. 2012;40:226-234.
Lee HS, Park YS, Lee JS, et al. Serum and seminal plasma insulin-like growth factor-1 in male infertility. Clin Exp Reprod Med. 2016;43:97-101.
Keck C, Gerber-Schafer C, Clad A, et al. Seminal tract infections: impact on male fertility and treatment options. Hum Reprod Update. 1998;4:891-903.
Dieterle S. Urogenital infections in reproductive medicine. Andrologia. 2008;40:117-119.
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1-34.
Howick J, Chalmers I, Glasziou P, et al. OCEBM Levels of Evidence Working Group. “The Oxford Levels of Evidence 2″. http://www.cebm.net/index.aspx?o=5653.
DerSimonian R, Kacker R. Random-effects model for meta-analysis of clinical trials: an update. Contemp Clin Trials. 2007;28:105-114.
Souza JP, Pileggi C, Cecatti JG. Assessment of funnel plot asymmetry and publication bias in reproductive health meta-analyses: an analytic survey. Reprod Health. 2007;4:3.
Salmeri M, Santanocita A, Toscano MA, et al. Chlamydia trachomatis prevalence in unselected infertile couples. Syst Biol Reprod Med. 2010;56:450-456.
Eley A, Pacey AA. The value of testing semen for Chlamydia trachomatis in men of infertile couples. Int J Androl. 2011;34:391-401.
Vilvanathan S, Kandasamy B, Jayachandran AL, et al. Bacteriospermia and Its Impact on Basic Semen Parameters among Infertile Men. Interdiscip Perspect Infect Dis. 2016;2016:2614692.
Gallegos-Avila G, Ortega-Martinez M, Ramos-Gonzalez B, et al. Ultrastructural findings in semen samples of infertile men infected with Chlamydia trachomatis and mycoplasmas. Fertil Steril. 2009;91:915-919.
Habermann B, Krause W. Altered sperm function or sperm antibodies are not associated with chlamydial antibodies in infertile men with leucocytospermia. J Eur Acad Dermatol Venereol. 1999;12:25-29.
Jamalizadeh Bahaabadi S, Mohseni Moghadam N, Kheirkhah B, et al. Isolation and molecular identification of Mycoplasma hominis in infertile female and male reproductive system. Nephrourol Mon. 2014;6:e22390.
Mohseni Moghadam N, Kheirkhah B, Mirshekari TR, et al. Isolation and molecular identification of mycoplasma genitalium from the secretion of genital tract in infertile male and female. Iran J Reprod Med. 2014;12:601-608.
Mandar R, Raukas E, Turk S, et al. Mycoplasmas in semen of chronic prostatitis patients. Scand J Urol Nephrol. 2005;39:479-482.
Samra Z, Soffer Y, Pansky M. Prevalence of genital chlamydia and mycoplasma infection in couples attending a male infertility clinic. Eur J Epidemiol. 1994;10:69-73.
Al-Mously N, Cross NA, Eley A, et al. Real-time polymerase chain reaction shows that density centrifugation does not always remove Chlamydia trachomatis from human semen. Fertil Steril. 2009;92:1606-1615.
Dehghan Marvast L, Aflatoonian A, Talebi AR, et al. Semen inflammatory markers and Chlamydia trachomatis infection in male partners of infertile couples. Andrologia. 2016;48:729-736.
Pajovic B, Radojevic N, Vukovic M, et al. Semen analysis before and after antibiotic treatment of asymptomatic Chlamydia- and Ureaplasma-related pyospermia. Andrologia. 2013;45:266-271.
de Barbeyrac B, Papaxanthos-Roche A, Mathieu C, et al. Chlamydia trachomatis in subfertile couples undergoing an in vitro fertilization program: a prospective study. Eur J Obstet Gynecol Reprod Biol. 2006;129:46-53.
Hosseinzadeh S, Eley A, Pacey AA. Semen quality of men with asymptomatic chlamydial infection. J Androl. 2004;25:104-109.
De Francesco MA, Negrini R, Ravizzola G, et al. Bacterial species present in the lower male genital tract: a five-year retrospective study. Eur J Contracept Reprod Health Care. 2011;16:47-53.
Lee JS, Kim KT, Lee HS, et al. Concordance of Ureaplasma urealyticum and Mycoplasma hominis in infertile couples: impact on semen parameters. Urology. 2013;81:1219-1224.
Motrich RD, Cuffini C, Oberti JP, et al. Chlamydia trachomatis occurrence and its impact on sperm quality in chronic prostatitis patients. J Infect. 2006;53:175-183.
Rodin DM, Larone D, Goldstein M. Relationship between semen cultures, leukospermia, and semen analysis in men undergoing fertility evaluation. Fertil Steril. 2003;79 Suppl 3:1555-1558.
Rybar R, Prinosilova P, Kopecka V, et al. The effect of bacterial contamination of semen on sperm chromatin integrity and standard semen parameters in men from infertile couples. Andrologia. 2012;44 Suppl 1:410-418.
El Feky MA, Hassan EA, El Din AM, et al. Chlamydia trachomatis: methods of identification and impact on semen quality. Egypt J Immunol. 2009;16:49-59.
Knox CL, Allan JA, Allan JM, et al. Ureaplasma parvum and Ureaplasma urealyticum are detected in semen after washing before assisted reproductive technology procedures. Fertil Steril. 2003;80:921-929.
Huang C, Long X, Jing S, et al. Ureaplasma urealyticum and Mycoplasma hominis infections and semen quality in 19,098 infertile men in China. World J Urol. 2016;34:1039-1044.
Gallegos G, Ramos B, Santiso R, et al. Sperm DNA fragmentation in infertile men with genitourinary infection by Chlamydia trachomatis and Mycoplasma. Fertil Steril. 2008;90:328-334.
Gdoura R, Kchaou W, Chaari C, et al. Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis and Mycoplasma genitalium infections and semen quality of infertile men. BMC Infect Dis. 2007;7:129.
Grizard G, Janny L, Hermabessiere J, et al. Seminal biochemistry and sperm characteristics in infertile men with bacteria in ejaculate. Arch Androl. 1985;15:181-186.
Kokab A, Akhondi MM, Sadeghi MR, et al. Raised inflammatory markers in semen from men with asymptomatic chlamydial infection. J Androl. 2010;31:114-120.
Sanocka-Maciejewska D, Ciupinska M, Kurpisz M. Bacterial infection and semen quality. J Reprod Immunol. 2005;67:51-56.
Wang Y, Liang CL, Wu JQ, et al. Do Ureaplasma urealyticum infections in the genital tract affect semen quality? Asian J Androl. 2006;8:562-568.
Bussen S, Zimmermann M, Schleyer M, et al. Relationship of bacteriological characteristics to semen indices and its influence on fertilization and pregnancy rates after IVF. Acta Obstet Gynecol Scand. 1997;76:964-968.
Andrade-Rocha FT. Colonization of Gardnerella vaginalis in semen of infertile men: prevalence, influence on sperm characteristics, relationship with leukocyte concentration and clinical significance. Gynecol Obstet Invest. 2009;68:134-136.
Moskovtsev SI, Mullen JB, Lecker I, et al. Frequency and severity of sperm DNA damage in patients with confirmed cases of male infertility of different aetiologies. Reprod Biomed Online. 2010;20:759-763.