Impact of asymptomatic urogenital tract infections on ejaculate parameters in infertile men with varicocele

Abstract

Varicocele, a pathology developing in 15 % males, is associated with 30 % male infertility cases. The role of urogenital infections coinciding with varicocele in infertile men has not been studied in sufficient detail.Objective: to examine the effects of bacterial and viral infections on ejaculate parameters in infertile patients with varicocele. The study included 49 patients with infertility and varicocele and 26 healthy males undergoing prophylactic medical examination. Highlevel infection was recorded after examination of ejaculates and urethral scrapes of 49 patients: bacterial (30.6 %) and viral (14.3 %) pathogens. Quantitative analysis of viral DNA showed high contamination of ejaculates with herpes viruses (> 3 lg10/ml). Detailed analysis of spermatograms demonstrated a decrease in all basic parameters in patients with varicocele and infertility compared with those in healthy subjects. The presence of infectious agents had a statistically significant negative effect on ejaculate parameters. Spermiological examination revealed high level of sperm abnormalities (astenozoospermia, oligoteratozoospermia, and oligoastenoteratozoospermia) in patients with infertility, varicocele and bacterioviral infection of urogenital tract compared with uninfected infertile patients with varicocele. Laboratory tests for bacterial and viral infections should be recommended in infertility associated with varicocele even in the absence of clinical signs of these infections. Quantitative analysis of urogenital pathogens allows one to determine the necessity of etiotherapy of hidden infection and to monitor the effectiveness of treatment.

Keywords

• male infertility
• varicocele
• urogenital infection
• spermogram parameter
• pathozoospermia