Mycoplasmas y anticuerpos anti-Chlamydia en semen de hombres infértiles y su relación con la calidad seminal y los marcadores de glándulas sexuales accesorias masculinas / Mycoplasmas and antibodies anti-Chlamydia in semen of infertile men and their relationship with seminal quality and markers of male accessory sex glands

La infertilidad masculina puede deberse a inflamación o infección del tracto genital entre otras causas. En el problema de la infertilidad masculina pueden estar implicadas las glándulas sexuales accesorias y la función espermática. En este trabajo se trata de asociar los gérmenes más frecuentes en semen de hombres infértiles incluyendo Chlamydia trachomatis, Mycoplasma hominis y Ureaplasma urealyticum con las características seminales, y los niveles de fructosa, ácido cítrico y a-glucosidasa neutra como marcadores de las glándulas sexuales accesorias masculinas. La detección de los anticuerpos indicó que C. trachomatis fue el germen de mayor prevalencia. Los anticuerpos (Acs) anti-Chlamydia, Mycoplasma hominis y Ureaplasma urealyticum se asociaron con descenso de los marcadores glandulares fructosa y a-glucosidasa. Por otra parte se observó aumento del pH y leucocitospermia en los pacientes con Acs anti-Chlamydia. La evaluación microbiológica y la bioquímica del semen orientarían más sobre la propagación de la infección y permitiría seleccionar la terapia más efectiva. Se observó que es importante la evaluación microbiológica y de los marcadores de glándulas accesorias sexuales masculinas en el semen para diagnosticar y tratar las infecciones masculinas.

Male infertility may be due to inflammation or infection of the genital tract among other causes. Male accessory sex glands and sperm function may also be involved in the problem of infertility. This study tries to associate the most frequent bacteria in semen of infertile men including Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum with the seminal characteristics and levels of fructose, citric acid and a-neutral glucosidase as markers of the accessory glands. Detection of antibodies anti Chlamydia trachomatis indicated that it was the most prevalent germ. Antibodies (Ab) anti-Chlamydia, Mycoplasma hominis and Ureaplasma urealyticum were associated with a decrease of the glandular markers fructose and a-neutral glucosidase. On the other hand, there were increased pH and leukocytospermia in men positive for antibodies anti-Chlamydia. Microbiological and biochemical evaluation of semen could orient more about the spread of infection and allow for the selection of the most effective therapy. We find that microbiological and glandular accessory markers assessments in semen are important to diagnose and to treat infections.

[Comparison of anti Chlamydia antibodies in tubal and non-tubal infertile patients]

Chlamydia trachomatis infection is one of the most prevalent bacterial sexually transmitted infection in most countries. This organism may stay in genital tract for long time and cause subtle yet progressive damage in fallopian tubes. In this study we evaluate the correlation between chlamydia antibodies and tubal and other factors of infertility. In this case control study, 28 patients with tubal factor infertility, 28 patients with non tubal factor infertility and 30 normal patients were enroled. Presence or absence of tubal factor was assessed by direct vision via laparscopy, then titres of IgA and IgG were evaluated in all of them using ELISA method in the same labratory. Data were recoded and analyzed using SPSS software and chi-square, Fisher's exact, T-test and Mann- Whitney test. Positive titre of IgG was higher in tubal factor infertility but it was not statistically significant between three groups [p>0.294]. Positive titres of IgA were more common in non tubal factor infertility [p=0.007]. Though positive and negative titres of IgA [P=0.224] and IgG [P=0.273] were not statistically different in fertile and infertile patients. Positive and negative titres of IgA and IgG were also not statistically different in patients with or without PID [p>0.05]. No correlation was found between the positive titres of IgG and IgA against Chlamydia and tubal factor infertility

Immunocomb Chlamydia bivalent assay to study Chlamydia species-specific antibodies in patients with coronary heart disease.

BACKGROUND & OBJECTIVE: Serological evidences suggested an association between Chlamydia pneumoniae infection and coronary heart disease (CHD). Efficacy of available serological tests for detection of C. pneumoniae antibody has been debated. The present study was carried-out to assess the efficacy of Immunocomb Chlamydia bivalent IgG assay vis-à-vis micro immunofluorescence (MIF) test in detecting C. pneumoniae and C. trachomatis--specific antibodies in patients with CHD. METHODS: Serum samples collected from clinically confirmed cases of CHD (n=114) were subjected to Immunocomb Chlamydia bivalent assay and the standard MIF test. Antibodies specific to C. pneumoniae and C. trachomatis were detected quantitatively. RESULTS: Though Immunocomb Chlamydia bivalent test yielded 73.7 per cent positivity for C. pneumoniae- specific IgG antibody (compared to 50.8% by MIF), the specificity of Immunocomb was found only 32.14 per cent. Positive and negative predictive values of Immunocomb assay were 54.8 and 60.0 per cent respectively. INTERPRETATION & CONCLUSION: The findings of the present study indicated that though Immunocomb assay was inferior to MIF, it can be used as a method for presumptive serology due to its rapidity and ease of performance. Wherever possible, one or more additional tests should also be performed to increase the specificity of such studies.

Evidence of chlamydial infection in infertile women with fallopian tube obstruction.

The study was carried out to find the prevalence of Chlamydia trachomatis seropositivity among women with infertility of tubal origin. Forty women with tubal infertility (verified at hysterosalpingography and laproscopy), 20 women with infertility due to variety of other reasons and 20 healthy fertile women of reproductive age were enrolled in the study. It was found that the presence of Chlamydia specific IgG antibody was significantly higher (70%) in women with infertility of tubal origin as compared to 35% seropositivity in healthy fertile women and 55% seropositivity in infertile women with cause of infertility other than tubal factor. Seventy eight percent of women with frequency of coitus 3-4 times/week were seropositive as compared to 34.7% when frequency of coitus was 1-2 times/week. Study also showed the silent nature of this infection as history suggestive of past pelvic inflammatory disease (PID) was lacking in majority of the seropositive women (63.75%). In the study group, both the ends of the fallopian tubes (cornual and distal block) were involved with almost equal frequency. Eighty three percent of women with seropositivity had unilateral or bilateral hydrosalpinx and 75% of women had marked pelvic adhesions. These results support the fact that there is strong association between serum anti-Chlamydial antibodies and tubal factor as a cause of infertility in infertile women.