Mechanisms and effects of male genital tract infection on sperm quality and fertilizing potential: the andrologist's viewpoint

There are several mechanisms acting in synergism that can impair sperm char acteristics of patients with accessory gland infection. In some cases, conv entional sperm variables are disturbed with oligo and/or asthenozoospermia, In other patients, these sperm variables may appear normal, but the functi onal capacity of spermatozoa may be impaired. In particular, changes in the composition of the sperm membrane may result in reduced acrosome reactivit y and capacity to fuse with the oolemma, and oxidative damage of the sperm DNA may induce mutagenesis. Changes in the biochemical make-up of seminal p lasma can also reduce the in-vivo fertilizing capacity of spermatozoa, and infection-related disruption of the blood-testis barrier can induce the gen eration of anti-sperm antibodies and immunological infertility Many of thes e functional abnormalities,ill not become evident upon 'basic semen analysi s', which explains why some authors are unable to link infection of the acc essory sex glands to subfertility, Also, functional and anatomical damage a cquired as a result of infection is often permanent and not reversible by ( antibiotic) treatment. Clearly, there are many more aspects of male accesso ry gland infection that require investigation. Available data should stimul ate clinicians to place more emphasis on the prevention of infection-relate d infertility than on its treatment, as the latter is often unsuccessful.