Chlamydia trachomatis in andrologic patients - Direct and indirect detection

Background: Chlamydia trachomatis is considered to be the most common sexua lly transmitted disease in Germany. It is currently unclear whether chlamyd ial infection causes pathological conditions of the male accessory glands w ith consequences for male infertility. Patients and Methods: Within the framework of several prospective studies t he association between sperm quality, male accessory gland function and inf ection with C, trachomatis was investigated in men of couples with unexplai ned infertility, Chlamydial infection was determined by serologic methods a nd by proof of Chlamydia-specific DNA. As a marker of infection the direct determination of granulocytes in the ejaculate or the measurement of the po lymorphonuclear (PMN) elastase concentration was used. The male accessory g land function was evaluated using the markers fructose, citric acid and alp ha -glucosidase in the seminal plasma. Results: Chlamydia-specific DNA in the ejaculate was present in between 3-5 % of the subjects, which corresponds to its prevalence in the normal popula tion. Chlamydia ISA antibodies were demonstrated with a frequency of 38% in seminal plasma (n = 834) using a genus-specific test (rELISA). Using other species-specific tests (MIF, SeroCT, IgA pELISA and ImmunoComb), Chlamydia IgA antibodies were found at frequencies of between 8 and 22%. Conclusion: Only in a few individual cases was it possible to show a connec tion between reduced sperm quality, disturbed male accessory gland function and indication of infection with Chlamydia, bacteria or Ureaplasma.