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Online First

10.4103/aja202164

Association of sexually transmitted infection with semen quality in men from couples with primary and secondary infertility

Shun Bai1, Yuan Li2, Mei-Hong Hu1, Li Wu1, Li-Jun Shui1, Xiao-Han Wang3, Yi-Xun Liu4, Qiu-Ling Yue5, Li-Na Yu5, Kai-Qiang Fu6, Xian-Hong Tong1, Xue-Chun Hu4, Bo Xu1

1 Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
2 Dermatology Department, The Fifth People's Hospital of Hainan Province, Haikou 570100, China
3 Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, China
4 Department of Urology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
5 Reproductive Medicine Center, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
6 College of Veterinary Medicine, Qingdao Agricultural University, Qingdao 266109, China

Correspondence: Dr. B Xu (bio_xubo@163.com) or Dr. XC Hu (b091230028@163.com)

21-Sep-2021

Abstract

This study aims to compare the prevalence of sexually transmitted infections (STIs) with semen quality in men from couples with primary and secondary infertility. Semen samples were collected from 133 men who requested fertility evaluation. Seminal tract infection with Ureaplasma spp. (UU), Mycoplasma hominis (MH), Mycoplasma genitalium (MG), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and herpes simplex virus-2 (HSV-2) was assessed by PCR-based diagnostic assays. Among all patients, the prevalence of STIs was higher in men from couples with primary infertility than that in men from couples with secondary infertility (39.7% vs 21.7%, P = 0.03). The prevalence of UU was 28.8% and 13.3% in men from couples with primary and secondary infertility, respectively. Men from couples with primary infertility were more likely to be positive for UU than men from couples with secondary infertility (P = 0.04). Regarding the UU subtype, the prevalence of Ureaplasma urealyticum (Uuu) and Ureaplasma parvum (Uup; including Uup1, Uup3, Uup6, and Uup14) did not differ between the two groups. No associations between the prevalence rates of MH, MG, and CT were found in men from either infertility group. A lower sperm concentration was associated with STI pathogen positivity in men with primary infertility according to the crude model (P = 0.04). The crude and adjusted models showed that semen volume (both P = 0.03) and semen leukocyte count (both P = 0.02) were independently associated with secondary infertility. These findings suggest the importance of classifying the type of infertility during routine diagnosis of seminal tract infections.

Keywords: primary infertility; secondary infertility; semen parameters; sexually transmitted infections

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