Introduction
Various infectious agents can impair human functions, including reproduction. Male infertility is when the males cannot make a female pregnant. It may be due to abnormal sperm function, low sperm production, or any blockage preventing the delivery of sperm. In addition, many viruses, bacteria, fungi, and parasites can interfere with the reproductive system in the male. Around fifteen percent of male genital infections result in male infertility. It can include different sites, including the testis, epididymis, and male accessory sex organs. The infections can be sexually transmitted and non-sexually transmitted diseases. The typical microorganisms in sexually transmitted infections that can lead to male infertility include Chlamydia trachomatis and Neisseria gonorrhoeae. Non-sexually transmitted diseases include epididymal-orchitis caused by microorganisms Escherichia coli. The most common cause of tubal blockage is Chlamydia trachomatis, and the incidence of Neisseria gonorrhoeae is declining. The other factors of male infertility include genital factors, steroid hormone disorders, ejaculation disorders, and reproduction infections. The incidence of male infertility varies in different countries. In developed countries, around ten percent of male infertility is due to genital infections. In developing countries, around fifty percent of male infertility is due to poor health and medical conditions.
What Types of Genital Infections Cause Male Infertility?
Many microorganisms can cause male infertility. These include bacteria, viruses, parasites, yeasts, and tropical infections. The causes of male infertility are as follows:
-
Bacterial Infections: Various bacteria are involved in genital infections and impair the male reproductive system. These include Escherichia coli, Staphylococcus aureus, Neisseria gonorrhoeae, Chlamydia trachomatis, and Staphylococcus saprophyticus.
-
Chlamydia trachomatis is found in epididymis, prostate, testis, and urethra. The microorganisms can infect the testicular cells within three days.
-
Neisseria gonorrhoeae causes inflammation of the urethra, prostate gland, and epididymis. It infects the tissues by attaching to the spermatozoa. There is less incidence of a relationship between N. gonorrhoeae and male infertility. However, it can lead to abnormal sperm production or reduced sperm fertilization.
-
Ureaplasma urelyticum can also cause inflammation of the epididymis, urethra, and prostate gland. In addition, it may affect sperm quality and decrease sperm motility.
-
Pseudomonas aeruginosa can lead to inflammation of the epididymis and urethra. It affects sperm motility.
-
Brucella can replicate, survive in the immune cells, and regulate the host response. As a result, it can spread to the tissues and increase in the male reproductive system and can lead to orchitis and epididymitis.
-
Escherichia coli is the most common bacterial infection affecting male infertility. The microorganism can lead to inflammation of the genitourinary system and failure of spermatogenesis. In addition, it can bind to the receptors of the gonads and result in an inflammatory response.
-
Viral Infection: Several viral infections can result in male infertility. It includes Human papillomavirus (HPV), human immunodeficiency virus (HIV), herpes simplex virus (HSV), zika virus, and ebola virus.
-
HPV is found in the male testis and can impair sperm motility. It has a prevalence of ten percent among the population. In addition, it results in the reduction of sperm indices.
-
HIV has two subtypes, 1 and 2. HIV load is lower in the semen than in the blood. It can result in orchitis, hypogonadism, and impaired sperm production. HIV reduces sperm motility. HIV patients have low testosterone levels and high luteinizing and follicular stimulating hormone levels.
-
Herpes simplex virus can be transmitted sexually and infects the mucosa of the penis. It can affect the male reproductive system and can cause damage to the spermatozoa.
-
Fungal Infection: The most common microorganism in male sterility is Candida albicans. The fungus can colonize the male urethra and is found in the semen. It can impair spermatozoa and result in male infertility.
-
Parasitic Infection: The common parasite involved in the male genital tract is Trichomonas vaginalis. The microorganism can cause inflammation of the urethra and prostate gland and lead to other genital disorders. In addition, it can inhibit male sperm motility and result in male infertility.
What Is the Mechanism by Which Genital Tract Infection Can Cause Male Infertility?
Genital infections can affect male infertility through direct and indirect damage. Bacteria, viruses, fungi, and parasites affect the testicular cells. They can damage the quality and functions of the sperm through pathogens, reactive oxygen species, or proinflammatory cytokines. These pathogens may lead to the dysfunction of the accessory glands of the male reproductive system. They may impair spermatogenesis, obstruct the ejaculatory ducts, and decrease sperm motility. In addition, the pathogens damage sperm cell production by inducing humoral and cellular immune responses. This can lead to the production of anti-sperm antibodies. The immune response may occur in the epididymis and testis and lead to male infertility.
How Can Male Infertility Due to Genetic Infections Be Diagnosed?
Various tests can diagnose genital infections. The test includes:
-
Clinical Diagnosis: Patient history is the most common diagnostic factor in diagnosing sexually transmitted diseases. The doctor may ask the patient about the sexual dysfunction-associated symptoms.
-
Urine Test: The doctor may recommend a urine test to check for infections. A glass test may help detect the condition's localization and inflammation in the male genital tract.
-
Semen Analysis: The doctor prescribes the test to analyze fertility by sperm motility and total sperm count. The inflammation includes proinflammatory cytokines.
-
Microbiological Testing: A doctor may prescribe secretions and urine samples for microbial testing. The test is used to determine the type of microorganism causing the infection. The test shows the best results if combined with nucleic acid amplification and culture.
How Can Male Infertility Due to Genital Infections Be Managed?
The main aim of the treatment is to eradicate or reduce the pathogen that causes genital infections. Antibiotic therapy in infertile males may relieve acute and symptomatic conditions. The doctor may prescribe antimicrobial treatment for sexually transmitted infection patients and non-steroidal anti-inflammatory drugs (NSAIDs) to treat the inflammation. NSAIDs can also improve the quality of ejaculation. Immunosuppressive drugs and glucocorticoids can be prescribed to help with reproduction. The surgeon may recommend surgical procedures for obstructing the epididymis and prostate glands.
Conclusion
Male infertility is when the male is unable to make a female pregnant. Bacteria, viruses, fungi, and parasites can lead to male infertility. They can cause inflammation and infection in the different parts of the male reproductive system and affect sperm count, quality, and motility. The couple visits the hospital when they fail to reproduce. The infections need to be diagnosed and treated early. Healthcare providers, including doctors and nurses, may educate patients and their families about genital infections and their treatment.
