Can Chlamydia trachomatis directly damage your sperm?

doi:10.1016/S1473-3099(04)01254-X

The Lancet Infectious Diseases

Volume 5, Issue 1, January 2005, Pages 53-57

https://doi.org/10.1016/S1473-3099(04)01254-X Get rights and content

Summary

Although Chlamydia trachomatis causes symptomatic infection in the lower genital tract of approximately 50% of men, its role in the upper genital tract is less well known. Moreover, for a number of reasons, mostly based on methodological aspects, the impact of chlamydia on semen quality is controversial. Overall, in-vivo studies of C trachomatis in men have provided conflicting evidence as to whether it is associated with reduced fertility. By contrast, in-vitro studies show that co-incubation of spermatozoa with chlamydia causes a significant decline in numbers of motile sperm and results in premature sperm death. Since evidence suggests that chlamydial lipopolysaccharide is the principal factor leading to sperm apoptosis, a new line of inquiry would be to measure the levels of lipopolysaccharide in semen and relate these to parameters of semen quality, including that of sperm function. If these new lines of inquiry are proven, this could lead to potentially novel approaches in the treatment of infertile men.

Section snippets

The role of C trachomatis in the human genital tract

Although up to two-thirds of all women who are infected with chlamydia are asymptomatic,³ the remainder often present initially with urethritis and/or cervicitis. Some of these infections then move up the genital tract to cause salpingitis and pelvic inflammatory disease; this may eventually lead to ectopic pregnancy or infertility. It is obvious, therefore, that chronic chlamydial infections in women can directly result in infertility.

Although much is known about the consequences of acute and

In-vivo studies of C trachomatis infection in men

In-vivo studies have provided conflicting evidence as to whether or not C trachomatis is associated with male infertility,³ with some authors concluding that perhaps the only important aspect of C trachomatis infection in men was as a reservoir of infection that could increase the probability of infection in women.⁸ Clearly, historical difficulties in accurately diagnosing infected individuals and discriminating between current and past infections have led to confusion in the interpretation of

In-vitro studies of C trachomatis infection in the male

Most in-vitro studies of C trachomatis infections in men have concentrated on examining the effect of the bacterium on sperm function directly, and therefore attempting to model what may be happening within the male or female reproductive tracts should spermatozoa encounter the bacterium there. A central theme of this line of inquiry has been the importance of bacterial adherence to spermatozoa and the notion that this may be a possible explanation as to how bacterial diseases could be spread

Proposed hypothesis of C trachomatis-sperm interactions and implications for future research

It is well known that Gram-negative bacteria may be causal in many serious diseases—perhaps most notably, meningococcal infection.²² Moreover, it is also well known that the principal complicating factor in such a disease is endotoxin (ie, lipopolysaccharide). However, although we have previously suggested that lipopolysaccharide in the genital tract might have an effect on fertility,²¹ at that time, there was no information on the pathogenesis of lipopolysaccharide acting on sperm. Evidence to

Search strategy and selection criteria

Data for this personal view were identified by searches of MEDLINE, and references from relevant articles; numerous articles were identified through searches of the extensive files of the authors. Search terms were “Chlamydia trachomatis”, “semen quality”, “male infertility”, “sperm function”, “lipopolysaccharide”, and “sperm apoptosis”.

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Cited by (110)

Infections and male infertility
2023, Progres en Urologie
Le rôle des infections urogénitales dans l’infertilité masculine fait depuis longtemps l’objet d’un débat.
Une recherche bibliographique limitée à la littérature en anglais chez l’homme publiée avant 5/2023 a permis après analyse de sélectionner 189 articles.
L’infertilité masculine est souvent d’étiologie multifactorielle, et il est important pour optimiser le pronostic de prendre en charge tous les facteurs correctibles, dont les causes infectieuses, qui représentent l’une des plus fréquentes étiologies. Les agents infectieux en cause dans les infections urogénitales sont le plus souvent bactériens ou viraux, plus rarement parasitaires. Ils peuvent infecter les voies séminales, les glandes accessoires masculines et/ou les testicules et aboutissent le plus souvent à une inflammation et à une augmentation du stress oxydant. Ces infections diminuent la fertilité masculine, notamment en altérant les paramètres du spermogramme et en augmentant la fragmentation de l’ADN du spermatozoïde. Pour ces raisons, la recherche d’une infection urogénitale doit être systématique avec anamnèse et examen clinique minutieux, échographie et examens bactériologiques systématiques et orientés par la clinique. Un traitement étiologique pourra être proposé en fonction du tableau et du germe en cause.
Cette revue devrait aider l’urologue à établir un diagnostic précis de la forme et de l’extension de l’infection, et lui permettre de définir une stratégie thérapeutique appropriée, adaptée au patient, afin d’obtenir les meilleures chances d’amélioration de la fertilité masculine.
The role of urogenital infections in male infertility has long been the subject of debate.
A bibliographic search limited to English-language literature on human subjects published before 5/2023 resulted in the selection of 189 articles.
Male infertility is often of multifactorial aetiology, and to optimise the prognosis it is important to manage all the factors that can be corrected, including infectious causes, which represent one of the most frequent aetiologies. The infectious agents involved in urogenital infections are most often bacterial or viral, and more rarely parasitic. They can infect the seminal tract, male accessory glands and/or testicles, and usually result in inflammation and increased oxidative stress. These infections reduce male fertility, in particular by altering spermogram parameters and increasing sperm DNA fragmentation. For these reasons, the search for a urogenital infection should be systematic, involving a careful history and clinical examination, ultrasound and systematic bacteriological tests guided by clinical findings. Aetiological treatment may be proposed depending on the picture and the germ involved.
This review should help the urologist to establish an accurate diagnosis of the form and extent of the infection, and enable him to define an appropriate therapeutic strategy, tailored to the patient, in order to obtain the best chances of improving male fertility.
The effect of Chlamydia infection on koala (Phascolarctos cinereus) semen quality
2021, Theriogenology
Although it is well established that chlamydial disease renders female koalas infertile, there has been limited research on its effects on male koala fertility, specifically sperm quality. This study determined whether chlamydial infection adversely affects semen quality of naturally infected koalas and spermatozoa recovered from Chlamydia negative koalas co-incubated in vitro with C. pecorum elementary bodies (EBs). Semen from 102 south-east Queensland sexually mature wild koalas exhibiting varying degrees of chlamydiosis and clinical signs of disease were assessed for semen quality and compared to 11 clinically healthy, Chlamydia-free captive male koalas. For in vitro studies, semen samples were collected from 6 Chlamydia-free captive koalas, and co-incubated over 24 h with high and low concentrations of C. pecorum EBs and sperm quality assessed. Wild koalas displaying severe signs of clinical disease with C. pecorum present in the semen had significantly greater sperm DNA damage (P = 0.0267). The total % of morphologically abnormal spermatozoa was highest in wild koalas that had severe signs of clinical disease but whose semen was negative for C. pecorum (P = 0.0328). This apparent contradiction is possibly associated with wild males having resolved the infection but still possessing underlining reproductive pathology. A higher incidence of loose head spermatozoa occurred in semen of wild koalas not infected with C. pecorum compared to those that were C. pecorum infected (P = 0.026). In vitro incubation of semen with C. pecorum significantly decreased sperm motility and viability over 24 h.
The occurrence and pathology of chlamydiosis in the male reproductive tract of non-human mammals: A review
2020, Theriogenology
Organisms belonging to the Family Chlamydiaceae are responsible for a broad range of diseases in humans, livestock, companion animals and non-domestic species. Infection of the reproductive organs can cause a range of syndromes of which sub- and infertility are the most frequently observed clinical manifestations. While the gross and histological lesions associated with the isolation of Chlamydiaceae from the non-human female reproductive tract are well documented, little attention has been given to the pathological effects of this infection in the male genital system. As such, the occurrence and importance of Chlamydia-associated disease in male non-human mammalian species is less well documented. In order to improve our understanding of the significance of chlamydiosis in domestic, laboratory and wild animals, this review provides an up-to-date summary of Chlamydia-associated male reproductive pathology, whether that infection occurs naturally or experimentally. Although most lesions in males are described as incidental and of minor significance, results of recent studies suggest that infection with Chlamydiaceae can adversely impact male fertility and/or be instrumental in disease transmission. Although in humans, bulls and mice Chlamydia infection has been associated with morphological and functional abnormalities of the spermatozoa, this review will focus on the gross and histological findings linked to the colonisation of the genital system by this pathogen. Advances in our understanding of male reproductive chlamydiosis are necessary for diagnostic and therapeutic strategies, as well as epidemiological and conservation studies.
Effects of bacteria on male fertility: Spermatogenesis and sperm function
2020, Life Sciences
Bacterial infection can negatively affect different parts of the male genital tract and subsequently cause impaired spermatogenesis and male fertility. However, most of the previous studies have focused on the infected organs of the male genital tract and there are not many studies that investigated the direct effect of bacteria on sperm and their mechanism of action. Interestingly, bacteria can induce different damages on sperm cells such as DNA fragmentation, cell membrane peroxidation, and acrosome impairment. Such negative effects can be mediated by bacteria-secreted toxins and metabolites or by direct attachment of bacteria on the sperm cells and subsequent activation of signaling pathways related to oxidative stress, apoptosis, and inflammation. These bacteria-induced changes can impair semen parameters and subsequently cause infertility. Given the significant destructive effect of some bacteria on sperm function and male fertility, in this study, we reviewed the impact of male urogenital bacteria on spermatogenesis and sperm functions as well as the underlying mechanisms by which the bacteria can damage sperm.
The Reproductive Microbiome: An Emerging Driver of Sexual Selection, Sexual Conflict, Mating Systems, and Reproductive Isolation
2020, Trends in Ecology and Evolution
Citation Excerpt :
For example, adhesion of Escherichia coli to sperm cells leads to sperm agglutination and destruction of the sperm plasma membrane, with negative consequences for sperm motility and ultrastructure (e.g., [24,25]). Alternatively, the release or active secretion of bacterial membrane proteins (e.g., porins or lipopolysaccharides) have been shown to impair sperm function, possibly through the inhibition of macrophagal function [26] or induction of excessive reactive oxygen species (ROS) production [22]. Additionally, the presence of bacteria can increase local leucocyte levels, which can in turn impact sperm function and integrity via the formation of ROS [27].
All multicellular organisms host microbial communities in and on their bodies, and these microbiomes can have major influences on host biology. Most research has focussed on the oral, skin, and gut microbiomes, whereas relatively little is known about the reproductive microbiome. Here, we review empirical evidence to show that reproductive microbiomes can have significant effects on the reproductive function and performance of males and females. We then discuss the likely repercussions of these effects for evolutionary processes related to sexual selection and sexual conflict, as well as mating systems and reproductive isolation. We argue that knowledge of the reproductive microbiome is fundamental to our understanding of the evolutionary ecology of reproductive strategies and sexual dynamics of host organisms.
Prevalence and role of IgG anti-Chlamydia trachomatis in a population of infertile men in Morocco
2019, Progres en Urologie
L’infertilité est un problème mondial de santé publique qui affecte 15 % des couples en âge de procréer. L’infertilité masculine est en cause dans 20 à 50 % des cas. Ces chiffres sont en nette augmentation de par le monde. Plusieurs facteurs peuvent être responsables de cette infertilité avec en particulier les facteurs hormonaux, génétiques, toxiques ou infectieux. Ces derniers sont dominés principalement par l’infection à Chlamydia. Parmi les complications les plus graves de cette infection, on retrouve les troubles de fertilité liés à l’urétrite, l’épididymite et à l’azoospermie totale irréversible chez l’homme et les obstructions tubaires et les grossesses extra-utérines chez la femme.
Déterminer la prévalence des IgG anti-Chlamydia trachomatis chez les hommes consultant pour infertilité et analyser l’association entre le contact antérieur avec cette bactérie et l’altération de la qualité du sperme et la fonction des spermatozoïdes.
Étude prospective sur 26 mois de 143 patients adressés au service pour bilan d’infertilité du couple. Les données démographiques, le caractère primaire ou secondaire de l’infertilité, les facteurs de risque (tabac, hernie inguinale, varicocèle et antécédents d’infections urogénitales), les paramètres spermatiques (volume, mobilité, PH, vitalité et anomalies morphologiques) ont été étudiés ainsi que la détermination du titre des IgG anti-C. trachomatis. La prévalence de l’infection à Chlamydia ainsi que son impact sur les différents paramètres du spermogramme ont été analysés.
L’âge moyen des patients était de 38,5 ± 8,55 ans. L’infertilité était primaire chez 72 % des patients. Parmi les patients, 54,5 % avaient un spermogramme anormal. Une sérologie Chlamydia était positive chez 37,1 % des patients dont 58,5 % avaient un spermogramme anormal. L’analyse des différents paramètres spermatiques chez les patients Chlamydia positive et Chlamydia négative retrouve une altération significative de la vitalité dans le groupe Chlamydia positive avec un OR à 2,41, p = 0,02, (IC95 % : 1,15–5,06).
La prévalence de l’infection à Chlamydia est élevée chez les hommes infertiles. Les IgG anti-Chlamydia seraient associés à une altération de la vitalité des spermatozoïdes sans altération significative des autres paramètres spermatiques.
3.
Infertility is a global public health problem that affects 15% of couples of childbearing age. Male infertility is involved in 20 to 50% of cases. These figures are sharply increasing around the world. Several factors may be responsible for this infertility with especially hormonal, genetic, toxic or infectious factors. The latter are dominated mainly by Chlamydia infection. Among the most serious complications of this infection are infertility related to urethritis, epididymitis and irreversible total azoospermia in men and tubal obstructions and ectopic pregnancies in women.
To determine the prevalence of IgG anti-Chlamydia trachomatis in men consulting for infertility and the association between previous contact with this bacterium and the impairment of sperm quality and sperm function.
Prospective study over 26 months of 143 patients referred to the service for infertility assessment of the couple. Demographic data, primary or secondary character of infertility, risk factors (tobacco, inguinal hernia, varicocele and history of urogenital infections), semen parameters (volume, mobility, pH, vitality and morphological abnormalities) were studied as well as the determination of the anti-C. trachomatis IgG titer. The prevalence of Chlamydia infection and the association of the infection and alteration of the various parameters of the semen were analyzed.
The average age of patients was 38.5 ± 8.55. Infertility was primary in 72% of patients. Among the patients, 54.5% had an abnormal spermogram. Chlamydia IgG antibodies were positive in 37.1% of patients whose 58.5% had abnormal spermogram. Analysis of sperm parameters of patients with and without IgG C. trachomatis showed an altered vitality in Chlamydia positive patients with an OR at 2.41, P = 0.02, (95% CI: 1.15–5.06).
The prevalence of Chlamydia infection is high in infertile male. C. trachomatis IgG antibodies may be associated with an alteration of spermatozoa vitality without significant impairment of other semen parameters.
3.

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Personal ViewCan Chlamydia trachomatis directly damage your sperm?

Summary

Section snippets

The role of C trachomatis in the human genital tract

In-vivo studies of C trachomatis infection in men

In-vitro studies of C trachomatis infection in the male

Proposed hypothesis of C trachomatis-sperm interactions and implications for future research

Search strategy and selection criteria

J Urol

Fertil Steril

Fertil Steril

Fertil Steril

FEMS Microbiol Lett

Fertil Steril

Free Rad Biol Med

Fertil Steril

Renewing the focus. HIV and other sexually transmitted infections in the United Kingdom in 2002. London: Health Protection Agency, Nov 2003

Chlamydia

Update on the impact of Chlamydia trachomatis infection on male fertility

Andrologia

C trachomatis as a cause of acute Ôidiopathic' epididymitis

N Engl J Med

Detection of Chlamydia trachomatis by the polymerase chain reaction in young patients with acute epididymitis

Eur J Clin Microbiol Inf Dis

Genital infections in men

Br Med Bull

Male infertility and genital chlamydial infection: victim or perpetrator

Andrologia

Demonstration of Chlamydia trachomatis IgG antibodies in the male partner of the infertile couple is correlated with a reduced likelihood of achieving a pregnancy

Hum Reprod

Semen quality of men with aymptomatic chlamydial infection

J Androl

Chlamydia trachomatis infection in male partners of infertile couples: incidence and sperm function

Andrologia

Personal View
Can Chlamydia trachomatis directly damage your sperm?