Association of ureaplasma urealyticum with abnormal reactive oxygen species levels and absence of leukocytospermia

Purpose: Ureaplasma urealyticum is a commensal of the lower genitourinary t ract of many sexually active adults. The organism is more common in partner s of infertile than fertile marriages. We conducted a prospective study at our tertiary care center to confirm a possible association between U. ureal yticum and abnormal sperm function parameters. Materials and Methods: A total of 50 consecutive male patients seeking gene ral urology consultation for lower urinary tract symptoms characteristic of chronic prostatitis were evaluated. Urine and semen localization cultures were performed with additional semen cultures for U. urealyticum, Chlamydia trachomatis and Mycoplasma hominis. Specimens from 21 healthy men were use d as controls. Specimens were analyzed by a computer assisted semen analyze r, and verified manually for concentration, percent motility and morphology . Leukocytospermia was measured by the Endtz test. Semen specimens were als o analyzed for reactive oxygen species (ROS), acrosome reaction and mannose binding assay. Results: Of the patients 17 had positive U. urealyticum cultures and the ot her cultures were negative. Patients with U. urealyticum had significantly higher ROS levels (log [ROS + 1] = 2.52 +/- 0.25) than those without U. ure alyticum (1.49 +/- 0.20, p = 0.002) or controls (1.31 +/- 0.19, p = 0.002). Leukocytospermia was detected in only 1 of the 17 (6%) positive specimens and 4 (12%) negative specimens. Conclusions: Seminal ROS levels are elevated among patients with U. urealyt icum. ROS induces lipid peroxidation, which reduces membrane fluidity and s perm fertilization capability, and may be the mechanism by which U. urealyt icum impairs sperm function. Absence of leukocytospermia does not exclude U . urealyticum.