Prevalence of Chlamydia trachomatis asymptomatic urethritis among infertile men with oligoasthenozoospermia

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Abstract

Purpose

To investigate the prevalence of Chlamydia trachomatis in a group of infertile patients with oligoasthenozoospermia and asymptomatic urethritis and to assess the relationship between chlamydial infection and semen quality.

Patients and methods

Two hundred and fifty male patients with a history of primary infertility and idiopathic oligoasthenozoospermia were recruited from the Andrology and STD’s outpatient clinic, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University. The exclusion criteria included any evidence of urinary tract infection or any clinical symptoms of urethritis. Urine examination and detection of C. trachomatis by nested-PCR was performed for cases with the positive first glass.

Results

The incidence of asymptomatic urethritis among infertile men was 20% (50 patients out of 250), and this urethritis-positive group showed chlamydial DNA in the first voided urine in 30% of the urethritis-positive infertile men (15 patients). Urethritis-positive infertile men had a significantly lower sperm motility and sperm count and significantly higher abnormal forms.

Conclusion

Infertility in the couples with proved chlamydial infection may be related to the microbiological pathogen. Asymptomatic urethritis can be a factor in the deterioration of semen parameters, whether the cause of urethritis is Chlamydia spp. or another pathogen; however, an accurate diagnosis of Chlamydia spp. by nested PCR is necessary to guide specific effective therapy.

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