Prevalence and association of Chlamydia trachomatis, Ureaplasma spp. and Mycoplasma hominis urogenital infections in patients with primary infertility

PAIRA, DANIELA A.; TISSERA, ANDREA D.; MOLINA, ROSA I.; OLMEDO, JOSE J.; MOTRICH, RUBEN D.

Buenos Aires

Congreso; Reunión de Sociedades de Biociencias 2021; 2021

Currently, infertility affects 15-20% of couples of reproductive age worldwide, with women and men equally contributing to infertility cases. Among others, urogenital infections are known causes of infertility. In fact, infertility have been associated to Chlamydia trachomatis (Ct), Ureaplasma spp. (Uu) and Mycoplasma hominis (Mh) urogenital infections. However, evidence from large studies assessing their prevalence and putative associations in patients with infertility is still scarce. Herein, we aimed to evaluate the prevalence and associations of Ct, Uu and Mh infection in women and men seeking care for infertility. A cohort of 5464 patients with a diagnosis of couple’s primary infertility and 404 control individuals were enrolled. Cervical-swab and semen samples were collected from female and male individuals, respectively, and infections assessed by PCR or culture. Overall, the prevalence of Ct, Uu and Mh urogenital infection was significantly higher in patients than in control individuals (5.3%, 22.8% and 7.4% versus 2.0%, 17.8% and 1.7%, respectively). Ct infection was more prevalent in male than in female patients (OR: 1.36, p=0.034), being males younger than 25 years at the highest risk (OR: 2.51, p=0.002). Conversely, Uu and Mh infections were more prevalent in female patients, since males were less likely at risk of Uu (OR: 0.52, p<0.001) and Mh (0.41, p<0.001) infection. In addition, Uu infection was more prevalent in patients younger than 25 years, either in women (OR: 2.27, p=0.003) or men (OR: 1.66, p=0.034). Finally, a significant association between Mh and Uu infections was found in either female (OR: 33.84, p<0.0001) or male (OR: 71.83, p<0.0001) patients. Our data revealed that Ct, Uu and Mh are prevalent uropathogens in patients with couple’s primary infertility. Taken together, our results show the importance of including the screening of urogenital infections in the diagnostic work up of male infertility.