Schistosomiasis (bilharziasis) and male infertility.

Schistosomiasis (bilharziasis) is an endemic parasitic disease of a major source of morbidity and mortality for developing countries. It is caused by different species of blood flukes (trematode worms) of the genus Schistosoma, the most important of which are S. haematobium which infests the genitourinary tract and S. mansoni and S. japonicum which infest the gastrointestinal tract. The incidence of schistosome-induced male infertility is not known and probably underestimated being overshadowed by the more severe and often fatal urinary and gastrointestinal complications. Several causes may contribute to schistosomiasis-induced male infertility, such as hormonal imbalance, testicular tissue damage and genital ductal system obstruction, in addition to decreased libido and erectile dysfunction due to associated hormonal imbalance and prostatic infestation. Demonstration of the schistosome ova in seminal plasma or testicular tissue confirms the diagnosis. Treatment of schistosomiasis-induced male infertility depends on clinical evaluation and includes, besides anthelmintic treatment, hormonal replacement and assisted reproduction (IVF/ICSI) in cases of severe oligozoospermia and or obstructive and nonobstructive azoospermia.

Trichomonas vaginalis as a rare cause of male factor infertility at a hospital in East Anatolia.

Trichomonas vaginalis is known as an important cause of sexually transmitted infection in developing countries. The prevalence and spectrum of Trichomonasis in men are less characterised. We analysed the presence of T. vaginalis in 80 infertile men using wet mount microscopy, Giemsa staining, culture and PCR methods. We found 2.5% positivity for T. vaginalis using PCR method. Wet mount microscopy was ineffective. Giemsa staining and culture tests were positive only in one patient. Both of our PCR-positive patients were symptomatic. Our findings suggest that T. vaginalis should be considered for the aetiology of male factor infertility, although it is rare in developed countries.

Sequential testicular and epididymal damage in Zebu bulls experimentally infected with Trypanosoma vivax.

Six Zebu bulls aged between 31 and 34 months exhibiting good libido were used to study sequential testicular and epididymal damage in Trypanosoma vivax infection. Three bulls were infected with T. vivax, while the other three served as controls. All infected bulls became parasitaemic by day 5 post-infection and developed clinical trypanosomosis with rapidly developing anaemia. Representative bulls, one from each of the infected and control groups, were sacrificed on days 14, 28 and 56 post-infection. Testes and epididymides from these animals were studied histopathologically after processing and staining with haematoxylin and eosin (H and E). Testicular degeneration developed in all the infected bulls characterized by depletion of spermatogenic cells and destruction of interstitial tissue. The most severe testicular degeneration occurred in the bull that was sacrificed 56 days post-infection. Epididymal sperm reserves were 36%, 4% and 0%, respectively, in infected bulls that were sacrificed on days 14, 28 and 56 post-infection. The 0% epididymal sperm reserve may suggest complete cessation of spermatogenesis. It was concluded from this study that T. vivax infection of Zebu bulls could cause severe testicular and epididymal damage that may result in infertility or even sterility of the affected animals at early infection stages not previously thought.

[Toxoplasma infection in males with sterility in Shenyang, China].

OBJECTIVE: To investigate the Toxoplasma gondii (TOX) infection in males with sterility and the effect of the infection on the reproductive function of males. METHODS: Enzyme linked immunoabsorbent assay (ELISA) was used to detect TOX-CAg, TOX-IgG and TOX-IgM in the peripheral blood of male patients with sterility. RESULTS: Among 100 cases of male sterility, 7 were TOX-IgG positive (7%), 16 TOX-IgM positive (16%) and 13 TOX-CAg positive (13%). Among 100 normal males, 7 were TOX-IgG positive (7%), 3 TOX-IgM positive (3%) and 1 TOX-CAg positive (1%). CONCLUSION: TOX infection may affect the fertility of males and cause male sterility. For this reason, males should prevent themselves from TOX infection.

Trypanosomiasis-induced infertility in dromedary (Camelus dromedarius) bulls: changes in plasma steroids concentration and semen characteristics.

The effect of Trypanosomiasis on concentrations of plasma steroids and semen characteristics was studied in 24 dromedary bulls. Based upon the parasitological and serological diagnosis, 18 bulls were found infected with Trypanosoma evansi (Group 2) and six were found to be free from infection and served as controls (Group 1). The infected animals exhibited signs of anaemia indicated by the decrease of packed cell volume (PCV) and haemoglobin concentration (Hb), pale mucus membranes, weight loss, lethargy, weakness and dullness. However, five animals (27.8%) of the infected group revealed elevated rectal temperatures and three animals (16.7%) revealed testicular degeneration upon palpation of their scrotal contents. Concentrations of plasma oestradiol-17beta (86.5 +/- 8.6 pg/ml versus 232.5 +/- 74.4 pg/ml) and testosterone (4.8 +/- 0.7 ng/ml versus 2.7 +/- 1.5 ng/ml) were significantly different (P < 0.05) between the control and infected bulls. Evaluation of the semen collected by electroejaculation and evaluated by a computerized cell motion analyzer revealed normal semen characteristics in the control animals compared to deteriorated ones in the infected bulls. There were highly significant (P < 0.01) decreases in sperm count (12.2 +/- 1.3/ml versus 6.5 +/- 4.9 x 10(6)/ml), motility percentage (68.2 +/- 6.7% versus 27.4 +/-15.6%), percentage of live spermatozoa (73.2 +/- 8.3% versus 35.8 +/- 8.2%) and increases in percentage of morphological abnormalities (3.3 +/- 0.6% versus 15.9 +/- 1.0%) in the infected group. An examination of the plasma hormonal profiles and semen characteristics in the infected bulls indicated that altered Sertoli cell function due to formation of immune complexes in four bulls (Group 2A), pituitary dysfunction in six bulls (Group 2B), testicular degeneration in three bulls (Group 2C) and finally trypanotolerancy in five bulls (Group 2D) are possible factors responsible for poor semen characteristics and infertility induced by T. evansi infection in dromedary bulls.

[Etiological study of low fertility in eastern Gaboon. III. Filarial endemicity (Loa loa, D. perstans). Prevalence of microfilariae in hydroceles (author's transl)]. / Enquête sur l'étiologie de l'hypofécondité au Gabon oriental: III. Endémie filarienne (Loa loa, D. perstans). Fréquence des microfilaires dans les hydrocéles.

During an inquiry performed in Gaboon the prevalence of hydroceles had led to puncture systematically every vaginal flow. 68 fluids were so collected at the end of the inquiry. Subsequently the statistical analysis of the results in men seems to suggest a correlation between microfilaremia (Loa loa and D. perstans) and the prevalence of hydroceles. Microfilariae were found in 77% according to the following distribution: Loa loa seldom diagnosed in this kind of flow were detected in 10%; D. perstans although never reported so far in hydrocele fluids appeared to be present in 62%. O. volvulus more currently referred to in hydrocele liquids were scarcely traced.

[Survey of infection of Toxoplasma gondii in infertile couples in Suzhou countryside].

OBJECTIVES: To determine the level of anti-Toxoplasma antibody in serum of infertile couples to explore the relationship between toxoplasma infection and infertility. METHODS: Enzyme-linked immunosorbent assay (ELISA) was applied to detect the anti-Toxoplasma antibody, antisperm antibody (AsAb) and anticardiolipin antibody (ACA) in serum of 178 couples with infertility and 190 couples who had normal pregnant history. RESULTS: The positive result of Toxoplasma infection in the infertile couples was significantly higher than that in fertile couples which was 34.83% vs 12.11% (chi 2 = 26.72, P < 0.01) with the odds ratio 3.88. The positive result of serum AsAb in the Toxoplasma infected group was significantly higher than that in the no Toxoplasma infected group (32.50% vs 15.94%, chi 2 = 10.76, P < 0.01) with the odds ratio 2.54. CONCLUSIONS: Toxoplasma infection was related to infertility. The Toxoplasma infection and was posibly related to the antisperm antibodies which can be involved in the pathogenisis of infertility.

Microbiological investigation in male infertility: a practical overview.

The roles of inflammation and/or infection of the male accessory sex glands are very important for the potential effects that these conditions may have on male fertility. The clinical andrologist should be aware of the pathophysiological role of the main determinants of sperm damage when these conditions occur, in particular, seminal leukocytes, oxidative stress and cytokines. In addition, it is important to have a good knowledge of the methodologies to be used in clinical practice. This article summarizes the methods used to look for and to identify the micro-organisms responsible for male urogenital tract infections. These include sperm culture, urine culture, urethral swabbing, the Meares-Stamey test and balanopreputial swabbing. Finally, we discuss the role of human papilloma virus infection in male infertility.

Male infertility: a public health issue caused by sexually transmitted pathogens.

Sexually transmitted diseases (STDs) are caused by several pathogens, including bacteria, viruses and protozoa, and can induce male infertility through multiple pathophysiological mechanisms. Additionally, horizontal transmission of STD pathogens to sexual partners or vertical transmission to fetuses and neonates is possible. Chlamydia trachomatis, Ureaplasma spp., human papillomavirus, hepatitis B and hepatitis C viruses, HIV-1 and human cytomegalovirus have all been detected in semen from symptomatic and asymptomatic men with testicular, accessory gland and urethral infections. These pathogens are associated with poor sperm quality and decreased sperm concentration and motility. However, the effects of these STD agents on semen quality are unclear, as are the effects of herpes simplex virus type 1 and type 2, Neisseria gonorrhoeae, Mycoplasma spp., Treponema pallidum and Trichomonas vaginalis, because few studies have evaluated the influence of these pathogens on male infertility. Chronic or inadequately treated infections seem to be more relevant to infertility than acute infections are, although in many cases the exact aetiological agents remain unknown.

Subclinical leishmaniasis associated with infertility and chronic prostatitis in a dog.

A stud dog was presented for acquired infertility. Haematospermia and teratozoospermia were found on two ejaculates 2 weeks apart. A presumptive diagnosis of prostatitis was made follo-wing ultrasound examination. An ultrasound-guided needle core biopsy was performed under general anaesthesia, revealing a mild chronic macrophagic and plasma cell prostatitis with intracytoplasmic amastigotes consistent with Leishmania spp. infection. Presence of Leishmania infantum, Leishmania donovani or Leishmania chagasi was confirmed by polymerase chain reaction in seminal plasma. Serology and serum protein electrophoresis confirmed the diagnosis of a subclinical active systemic leishmaniasis. A meglumine antimoniate and allopurinol treatment was given which clearly improved within 3 months both general condition and the quality of sperm. To the authors' knowledge, this is the first reported case of a prostatitis secondary to a Leishmania spp. infection. Subclinical systemic leishmaniasis should be considered in the differential diagnosis of infertility in dogs suffering from semen alterations.

Parasitic castration of a vertebrate: Effect of the cymothoid isopod, Anilocra apogonae, on the five-lined cardinalfish, Cheilodipterus quinquelineatus.

Parasitic castration, the specific blocking of host reproductive output by an individual parasite, is a host-parasite interaction common to many invertebrates, particularly crustaceans, echinoderms and molluscs. It can reduce host density, alter host population dynamics and the evolution of host life history traits. Here we show that parasitisation by a single female cymothoid isopod, Anilocra apogonae, castrates its vertebrate host, the five-lined cardinalfish, Cheilodipterus quinquelineatus. Parasitised male fish fail to mouthbrood their young. The gonads of parasitised fish are smaller and parasitised female fish have substantially fewer and smaller ova than do the gonads of unparasitised fish. As for parasitic castrators of invertebrate hosts, A. apogonae on C. quinquelineatus are uniformly dispersed amongst infested hosts (one adult female isopod per host), are site specific, and their body size is highly correlated with that of their host. These isopods are large relative to the body size of their hosts, averaging 3.8% of the weight of the host. Parasitised fish also weigh less and are shorter than unparasitised fish of the same age. Despite the presence of other potential hosts, A. apogonae only infests C. quinquelineatus. The consistency of the ecological correlates amongst known parasitic castrators suggests that the parasitic castrator host-parasite relationship will be recognised for other parasites of vertebrates.

The impact of treatment experiences on the course of infertility distress in male patients.

BACKGROUND: Previous research on infertile males has delivered equivocal findings on the course of infertility distress in males. The present longitudinal study examines whether there are differentials associated with specific treatment experiences (i.e. duration of treatment, the diagnosis received, and treatment failure of assisted reproductive technologies). METHODS: The sample consisted of 118 patients who twice visited an andrology clinic on their own initiative for fertility work-ups. Baseline and follow-up examinations were > or = 6 months apart. Prior to each fertility work-up, patients completed a questionnaire assessing distress due to infertility. RESULTS: No uniform course of distress could be detected. A significant interaction between treatment experiences indicated that distress rises significantly only in those patients who were in treatment > or = 17 months and experienced treatment failure between the first and the second psychological evaluation. For the diagnosis of male infertility, however, neither a direct nor an indirect impact was identified. CONCLUSION: The present study indicates that the interaction of specific treatment experiences is associated with changes in distress of infertile males.

Electron microscopy of Chlamydia trachomatis infection of the male genital tract.

Semen specimens and testicular and epididymis biopsy from a patient of an infertile marriage were examined by transmission electron microscopy. Intraepithelial vesicles containing C. trachomatis were present in remaining cytoplasmic droplets in spermatozoa, desquamated epithelial cells, and stereocilia from epididymis. Elementary bodies were demonstrated in connective tissue from testes and in Leydig cells. The association between the microorganisms and spermatozoa contribute to the decreased motility and necrospermia. The morphologic alterations in epididymis are responsible for decreased sperm maturation. The damage to Leydig cells can be demonstrated only by electron microscopy.

Microsurgical epididymal sperm aspiration with motile trophozoite cells but no spermatozoa.

This paper reports on a patient in whom the clinical diagnosis of obstructive azoospermia was made according to clinical observations, i.e. azoospermia, normal andrological examination, normal follicle stimulating hormone and a misleading histopathological report of a testicular biopsy. Microsurgical vasoepididymostomy failed to restore fertility, and as a last resort, microsurgical sperm aspiration was performed. Although flagellated cells were observed in the epididymal aspiration, no spermatozoa were observed and wet preparation of multiple testicular biopsies failed to demonstrate any spermatozoon. This patient was diagnosed to have a non-obstructive azoospermia, resulting from maturation arrest associated with trichomonas infection at the level of the epididymis.

[Prostatitis due to the circular form of trichomonas (author's transl)]. / Les prostatites à trichomonas formes rondes (T.F.R.).

The authors underline the frequency with which trichomoniasis is located in the prostate. In these cases the parasite is rarely in its trophozoite form but has a circular shape which resembles the resistant pseudocystic type. They are found by phase contrast microscopy after staining with 1% cresyl blue which makes the difference with white blood cells. Out of a total of 178 men presenting with urethroprostatic signs (urethral discharge and burning), sterility with oligospermia, or a history of dyspareunia, the circular type of trichomoniasis was found in 40 (22%) of the cases, with urethritis in 26 cases, and prostatitis in the other 14 patients. Two courses of treatment, at one month's interval, with Tinidazole (2 tablets daily for 6 days) or Nimorazole (2 tablets daily for 8 days) produced healing in 4 cases with urethroprostatic effections, disappearance of dyspareunia in 2 out of the 3 cases treated, and return of fertility in 3 out of 7 patients. An up-to-date list of references is given.