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  • Title: The significance of chlamydial genital infection in male infertility.
    Author: Nikkanen V, Terho P, Punnonen R, Meurman O.
    Journal: Arch Androl; 1980 Feb; 4(1):57-61. PubMed ID: 7356375.
    Abstract:
    Chlamydia trachomatis (C.tr.) is recognized as an aetiological agent in most cases of male nonspecific urethritis, post-gonococcal urethritis, and epididymitis. According to the recent view, C.tr. is considered capable of causing infertility in women, but up to date the significance of C.tr. in male infertility is unknown. According to our study, chlamydial genital infection seems to play a role in male infertility, but in lesser degree than in females. Male chlamydial infection seems to be less intense and more "distal" than female infection. The infection is apparently often quite symptomless. The incidence of genital chlamydial infection in male population evidently increases with age and promiscuity at least from the age of 20 to 30 years. The significance of Chalmydia trachomatis infection as a cause of male infertility was examined in 4 groups: 21 infertile male outpatients (group 1), 38 men from childless couples where the female partner had chlamydia serum IgC antibodies or= 128 (group 2), 63 venereal outpatients without urethritis (group 3), and 32 military recruits and 24 medical students as controls (group 4). Mean ages in the 4 groups were 32.5, 31.4, 29.1, and 21.1 years, respectively. Chlamydial antibody titers were determined by a single antigen immunofluorescence test. The percent of chlamydial antibody positive (or= 16) patients was 57 in group 1, 76 in group 2, and 59 in group 3. These rates were significantly higher than in the control group (p0.005, 0.001, and 0.001, respectively). Most of the high titers (or= 128) occurred in group 2, where the geometric mean titer (202) was also highest. Semen analysis revealed that 100% of those in group 1 and 21% of those in group 2 had pathological semen. Signs of infection were found in 4 cases (19%) in group 1 and 5 cases (13%) in group 2. There were many more defects (e.g., oligozoospermia, teratozoospermia, asthenozoospermia) in group 1 than in group 2. Chlamydia trachomatis is a known etiologic agent in most cases of male nonspecific urethritis, postgonococcal urethritis, and epididymitis. The finding that there were many chlamydial-positive patients with a high geometric mean titer and only a few, slight defects in the semen in group 2; whereas only half the men in group 1 were chlamydial-positive, with a low geometric mean titer and marked semen defects suggests that chlamydial infection has only a slight effect on semen. It is concluded that chlamydial genital infection plays a lesser role in male than female infertility and tends to be less intense and more distal in men than in women. The incidence of chlamydial infection in men increases with age and promiscuity between the ages of 20-30 years.
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