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Purpose:

Ureaplasma urealyticum is a commensal of the lower genitourinary tract of many sexually active adults. The organism is more common in partners of infertile than fertile marriages. We conducted a prospective study at our tertiary care center to confirm a possible association between U. urealyticum and abnormal sperm function parameters.

Materials and Methods:

A total of 50 consecutive male patients seeking general urology consultation for lower urinary tract symptoms characteristic of chronic prostatitis were evaluated. Urine and semen localization cultures were performed with additional semen cultures for U. urealyticum, Chlamydia trachomatis and Mycoplasma hominis. Specimens from 21 healthy men were used as controls. Specimens were analyzed by a computer assisted semen analyzer, and verified manually for concentration, percent motility and morphology. Leukocytospermia was measured by the Endtz test. Semen specimens were also analyzed for reactive oxygen species (ROS), acrosome reaction and mannose binding assay.

Results:

Of the patients 17 had positive U. urealyticum cultures and the other cultures were negative. Patients with U. urealyticum had significantly higher ROS levels (log [ROS + 1] = 2.52 ± 0.25) than those without U. urealyticum (1.49 ± 0.20, p = 0.002) or controls (1.31 ± 0.19, p = 0.002). Leukocytospermia was detected in only 1 of the 17 (6%) positive specimens and 4 (12%) negative specimens.

Conclusions:

Seminal ROS levels are elevated among patients with U. urealyticum. ROS induces lipid peroxidation, which reduces membrane fluidity and sperm fertilization capability, and may be the mechanism by which U. urealyticum impairs sperm function. Absence of leukocytospermia does not exclude U. urealyticum.

References

  • 1 : Mycoplasma interactions with immune system: Implications for disease pathology. Am Soc Microbiol1996; 62: 471. Google Scholar
  • 2 : Evidence by scanning electron microscopy for an association between spermatozoa and T-mycoplasmas in men of infertile marriage. Fertil Steril1975; 26: 1203. Google Scholar
  • 3 : Ureaplasma in semen and IVF. Hum Reprod1991; 6: 727. Google Scholar
  • 4 : Recovery of microorganisms in semen and relationship to semen evaluation. Fertil Steril1986; 45: 101. Google Scholar
  • 5 : Incidence des mycoplasmas sur la fertile masculine et feminine. Contracept Fertil Sex1985; 13: 665. Google Scholar
  • 6 : Polymerase chain reaction enzyme-linked immunosorbent assay detection of mycoplasma consensus gene in sperm with low oocyte penetration capacity. Fertil Steril1996; 66: 793. Google Scholar
  • 7 : Role of reactive oxygen species in male infertility. Urology1996; 48: 835. Google Scholar
  • 8 : Operational standards for CASA instruments. J Androl1993; 14: 385. Google Scholar
  • 9 : Accuracy of computer-assisted semen analysis in prefreeze and post-thaw specimens with high and low sperm counts and motility. Urology1998; 51: 306. Google Scholar
  • 10 : A rapid staining method for differentiating granulocytes from “germinal cells” in Papanicolaou-stained semen. Acta Cytol1974; 18: 2. Google Scholar
  • 11 : Positive myeloperoxidase staining (Endtz test) as an indicator of excessive reactive oxygen species formation in semen. J Assist Reprod Genet1995; 12: 70. Google Scholar
  • 12 : Head-specific mannose-ligand receptor expression in human spermatozoa is dependent on capacitation-associated membrane cholesterol loss. Hum Reprod1993; 8: 2141. Google Scholar
  • 13 : The effect of positive semen bacterial and Ureaplasma cultures on in-vitro fertilization success. Hum Reprod1996; 11: 2789. Google Scholar
  • 14 : The correlation of Ureaplasma urealyticum infection with infertility. Andrology1997; 29: 219. Google Scholar
  • 15 : Ureaplasma urealyticum reduces motility and induces membrane alterations in human spermatozoa. Hum Reprod1998; 13: 2756. Google Scholar
  • 16 : Evidence for superoxide dismutase and catalase in mollicutes and release of reactive oxygen species. Arch Biochem Biophys1990; 277: 74. Google Scholar
  • 17 : Effect of seminal oxidative stress on fertility after vasectomy reversal. Fertil Steril1999; 71: 249. Google Scholar
  • 18 : Varicocele is associated with elevated spermatozoal reactive oxygen species production and diminished seminal plasma antioxidant capacity. J Urol1999; 161: 1831. LinkGoogle Scholar
  • 19 : Seminal reactive oxygen species and sperm motility and morphology in men with spinal cord injury. Fertil Steril1997; 67: 1115. Google Scholar
  • 20 : Male genital mycoplasmas and Chlamydia trachomatis culture: its relationship with accessory gland function, sperm quality, and autoimmunity. Fertil Steril1990; 53: 331. Google Scholar
  • 21 : Association of antisperm antibodies with chronic nonbacterial prostatitis. Urology1990; 36: 154. Google Scholar
  • 22 : Reduced semen quality caused by chronic abacterial prostatitis: an enigma or reality?. Fertil Steril1994; 61: 1109. Google Scholar
  • 23 : Value of detecting leukocytospermia in the diagnosis of genital tract infection in subfertile men. Fertil Steril1998; 70: 315. Google Scholar
  • 24 : Ureaplasma urealyticum (T-mycoplasma) infection: does it have a role in male infertility?. J Urol1980; 124: 469. LinkGoogle Scholar
  • 25 : Is there a role for Chlamydia trachomatis and genital mycoplasma in male infertility?. Fertil Steril1987; 48: 337. Google Scholar
  • 26 : Ureaplasma urealyticum and Mycoplasma hominis detected by the polymerase chain reaction in the cervices of women undergoing in vitro fertilization: prevalence and consequences. J Assist Reprod Genet1995; 12: 610. Google Scholar
  • 27 : Ureaplasma urealyticum in semen: is there any effect on in vitro fertilization outcome?. Fertil Steril1999; 71: 523. Google Scholar
  • 28 : Analysis of the impact of intracellular reactive oxygen species generation on the structural and functional integrity of human spermatozoa: lipid peroxidation, DNA fragmentation and effectiveness of antioxidants. Hum Reprod1998; 13: 1429. Google Scholar
  • 29 : Reactive oxygen species: potential cause for DNA fragmentation in human spermatozoa. Hum Reprod1998; 13: 896. Google Scholar

From the Department of Urology, Andrology Research and Clinical Laboratory, Department of Biostatistics and Epidemiology, Microbiology and Laboratory Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio

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