Summary:
Objective: The objective of the prospective study was to assess whether there exists a relationship
between the results of positive laboratory tests for the presence of Chlamydia infection (asses-
sment of the presence of Chlamydia trachomatis in the ejaculate by the DNA amplification met-
hod, IgA and IgG antichlamydia antibodies in the ejaculate and serum), an abnormal
spermiogram and total number of sexual partners in men from infertile couples examined at the
Gynaecological and Obstetric Clinic of the First Medical Faculty, Charles University Prague.
Design: Prospective clinical study.
Setting: Department of Gynaec.-Obstet., the 1 st Medical Faculty of the Charles University, Prague,
Czech Republic - Institut of Clinical Biochemy, the 1 st Medical Faculty of Charles University,
Prague, Czech Republic.
Method: 101 men were examined. In all the spermiogram was evaluated according to WHO crite-
ria. Specific antichlamydial antibodies IgA and IgG in serum and the ejaculate were assessed by
the ELISA method. Evidence of the DNA portion of Chlamydia trachomatis was provided by the
MEIA method. Amplification of DNA by LCR was made on a Thermocycler. By means of an aimed
questionnaire the number of all sexual partners was assessed. The men were divided into three
groups with 1-5, 6-9 and with 10 or more partners. Patients where Chlamydia infection was
detected were treated with Ig Azitromycin and their spermiogram was checked 6-8 weeks after
treatment.
The results of the examination were tested by the chi square test.
Results: An abnormal spermiogram was found in 44 (44%) of the examined subjects. With the
increasing number of sexual partners the number of men with pathospermia increased. In none
LCR for the presence of Chlamydia trachomatis was positive in the ejaculate. In 15 examined
patients IgA antichlamydia antibodies were found in the ejaculate. At the same time in all an
abnormal spermiogram was found and 11 (73%) of them had six or more sexual partners. After
treatment in 8 (62%) of 13 (two did not attend the check-up) marked improvement of the spermio-
gram occurred.
Conclusion: IgA antichlamydial antibodies in the ejaculate proved in 62% of the examined men
with an abnormal spermiogram a useful indicator of infection in the genital tract. With the
increasing number of sexual partners the number of pathospermias increased.
Key words:
male infertility, Chlamydia trachomatis, abnormal spermiogram
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