Urogenital infections tied to infertility

Urogenital infections with Chlamydia trachomatis, Ureaplasma spp., and Mycoplasma hominis appear to increase the risk of couple’s primary infertility, reveals a recent study.

The researchers performed a cross-sectional analysis of 5,164 patients who had recently been diagnosed with couple’s primary infertility and in whom urogenital infections were confirmed using commercially available culture assays. A parallel group of 404 healthy controls was also included.

Overall, urogenital infections were significantly more prevalent in infertile patients than controls. C. trachomatis, for example, was detected in 5.3 percent of patients, as opposed to only 2.0 percent of controls (p=0.0032). The corresponding rates were 22.8 percent and 17.8 percent for Ureaplasma spp.  (p=0.0215) and 7.4 percent and 1.7 percent for Mycoplasma hominis (p<0.0001).

Stratifying according to sex revealed similar patterns, with only a few notable exceptions. In women, the rates of Chlamydia trachomatis infections were similar in patients and controls (p=0.6453). In men, Ureaplasma spp. was detected at comparable rates between patients and controls (p=0.7005).

Logistic regression analysis revealed that not only were these urogenital infections associated with sex but with age as well. C. trachomatis, for instance, was more than twice as likely to occur in men <25 years of age (vs >40 years; odds ratio [OR], 2.51, 95 percent confidence interval [CI], 1.40–4.48; p=0.002). Those between 25 and 40 years of age were less likely to contract the infection (p=0.021).

Moreover, women aged <25 years also saw more than twice the odds of Ureaplasma spp. infections (vs >40 years; OR, 2.27, 95 percent CI, 1.33–3.89; p=0.003).

“[T]hese results point out the importance to include the microbiological screening of urogenital infections in the diagnostic workup for infertility,” the researchers said.

“Future research is needed to unveil the true impacts of these uropathogens and the underlying pathophysiological mechanisms, which would allow the identification of proper and efficient treatments to more effectively reduce the burden of infertility,” they added.