Impact of bacterial infections in seminal fluid on delayed male fertility: A comparative study between case and control groups

S. A. S. Al-Sultan; W. S. Eid; I. A. Abdulhameed; Y. H. Thanoon

doi:10.15421/0225081

S. A. S. Al-Sultan Nineveh University
W. S. Eid University of Mosul
I. A. Abdulhameed University of Mosul
Y. H. Thanoon Nineveh University

Keywords: Enterococcus faecalis, male fertility, seminal fluid, Staphylococcus haemolyticus.

Abstract

Bacterial persistence in seminal fluid, known as bacteriospermia, is increasingly recognized as a significant contrib u tor to male infertility. This study investigates the prevalence of bacteriospermia in subfertile men, assesses its impact on semen quality, and identifies the specific bacterial species involved. This case-control study involved 78 male participants, divided into two groups: 39 men experiencing delayed c onception (case group) and 39 men with proven fertility (control group). P articipants were chosen b ased on predetermined inclusion and exclusion criteria,. Comprehensive questionnaires and clinical assessments were used in the data gathering process. Semen samples were collected and measured for volume, pH, sperm concentration, motility, morphology, and viability following WHO guidelines. Bacterial identification was done using Gram staining, culture methods, and the Vitek 2 system. In the case group, 79.5% of patients had bacterial persistence, while in the control group it was seen in 35.9%. Isolated bacteria in the case group most commonly included Staphylococcus haemolyticus , 25.6%; Enterococcus faecalis , 12.8%; and Staphylococcus lentus , 10.3%. S ubstantial di f ferences were recorded between case and control groups for sperm motility, concentration, and morphology. Moreover, the case group had higher percentages for smokers, wearers of tight clothing, consum ers of alcohol , and those accustomed to prolonged sitting, which were found to be statistically significant risk factors. This study underscores the pivotal role of bacterial persistence in seminal fluid in the aetiology of male infertility. Addressing bacteriospermia by using better dia g nostic and therapeutic strategies can improve reproductive outcomes and clinical care for affected individuals.

References

Boitrelle, F., Shah, R., Saleh, R., Henkel, R., Kandil, H., Chung, E., Vogiatzi, P., Zini, A., Arafa, M., & Agarwal, A. (2021). The sixth edition of the WHO manual for human semen analysis: A critical review and SWOT analysis. Life, 11(12), 1368.

Borges, E. D., Berteli, T. S., Reis, T. F., Silva, A. S., & Vireque, A. A. (2019). Microbial contamination in assisted reproductive technology: Source, prevalence, and cost. Journal of Assisted Reproduction and Genetics, 37(1), 53–61.

Costinar, L., Herman, V., Pitoiu, E., Iancu, I., Degi, J., Hulea, A., & Pascu, C. (2021). Boar semen contamination: Identification of gram-negative bacteria and antimicrobial resistance profile. Animals, 12(1), 43.

Eini, F., Kutenaei, M. A., Zareei, F., Dastjerdi, Z. S., Shirzeyli, M. H., & Salehi, E. (2021). Effect of bacterial infection on sperm quality and DNA fragmentation in subfertile men with leukocytospermia. BMC Molecular and Cell Biology, 22(1), 42.

Eltwisy, H. O., Twisy, H. O., Hafez, M. H., Sayed, I. M., & El-Mokhtar, M. A. (2022). Clinical infections, antibiotic resistance, and pathogenesis of Staphylococcus haemolyticus. Microorganisms, 10(6), 1130.

Emokpae, M. A., & Brown, S. I. (2021). Effects of lifestyle factors on fertility: Practical recommendations for modification. Reproduction and Fertility, 2(1), R13–R26.

Finelli, R., Mottola, F., & Agarwal, A. (2021). Impact of alcohol consumption on male fertility potential: A narrative review. International Journal of Environmental Research and Public Health, 19(1), 328.

Gachet, C., Prat, M., Burucoa, C., Grivard, P., & Pichon, M. (2022). Spermatic microbiome characteristics in infertile patients: Impact on sperm count, mobility, and morphology. Journal of Clinical Medicine, 11(6), 1505.

Gholami, M., Moosazadeh, M., Haghshenash, M. R., Jafarpour, H., & Mousavi, T. (2022). Evaluation of the presence of bacterial and viral agents in the semen of infertile men: A systematic and meta-analysis review study. Frontiers in Medicine, 9, 835254.

Guo, Y., Dong, Y., Zheng, R., Yan, J., Li, W., Xu, Y., Yan, X., Ke, Y., Li, Y., & Xiang, L. (2024). Correlation between viral infections in male semen and infertility: A literature review. Virology Journal, 21(1), 167.

Henkel, R. (2024). Leukocytospermia and/or bacteriospermia: Impact on male infertility. Journal of Clinical Medicine, 13(10), 2841.

Jendraszak, M., Skibińska, I., Kotwicka, M., & Andrusiewicz, M. (2024). The elusive male microbiome: Revealing the link between the genital microbiota and fertility. Critical review and future perspectives. Critical Reviews in Clinical Laboratory Sciences, 61(7), 559–587.

Kimmins, S., Anderson, R. A., Barratt, C. L. R., Behre, H. M., Catford, S. R., De Jonge, C. J., Delbes, G., Eisenberg, M. L., Garrido, N., Houston, B. J., Jørgensen, N., Krausz, C., Lismer, A., McLachlan, R. I., Minhas, S., Moss, T., Pacey, A., Priskorn, L., Schlatt, S., … O’Bryan, M. K. (2023). Frequency, morbidity and equity – the case for increased research on male fertility. Nature Reviews Urology, 21(2), 102–124.

Książczyk, M., Kuczkowski, M., Dudek, B., Korzekwa, K., Tobiasz, A., Korzeniowska-Kowal, A., Paluch, E., Wieliczko, A., & Bugla-Płoskońska, G. (2016). Application of routine diagnostic procedure, VITEK 2 compact, MALDI-TOF MS, and PCR assays in identification procedure of bacterial strain with ambiguous phenotype. Current Microbiology, 72(5), 570–582.

Liew, F. F., Dutta, S., & Sengupta, P. (2024). Fertility treatment-induced oxidative stress and reproductive disorders. Journal of Integrated Science and Technology, 12(3), 756.

Omolaoye, T. S., El Shahawy, O., Skosana, B. T., Boillat, T., Loney, T., & du Plessis, S. S. (2021). The mutagenic effect of tobacco smoke on male fertility. Environmental Science and Pollution Research, 29(41), 62055–62066.

Parameswari, R., & Sridharan, T. B. (2019). Cigarette smoking and its toxicological overview on human male fertility – a prospective review. Toxin Reviews, 40(2), 145–161.

Rotimi, D., & Singh, S. K. (2024). Implications of lifestyle factors on male reproductive health. JBRA Assisted Reproduction, 28(2), 320–330.

Saleh, A. S. (2023). Beware the IBM SPSS Statistics® in multiple ROC curves analysis. Internal and Emergency Medicine, 18(4), 1239–1241.

Schifano, N., Chiappini, S., Mosca, A., Miuli, A., Santovito, M. C., Pettorruso, M., Capogrosso, P., Dehò, F., Martinotti, G., & Schifano, F. (2022). Recreational drug misuse and its potential contribution to male fertility levels’ decline: A narrative review. Brain Sciences, 12(11), 1582.

Sciorio, R., Tramontano, L., Adel, M., & Fleming, S. (2024). Decrease in sperm parameters in the 21st century: Obesity, lifestyle, or environmental factors? An updated narrative review. Journal of Personalized Medicine, 14(2), 198.

Shah, R., Agarwal, A., Kavoussi, P., Rambhatla, A., Saleh, R., Cannarella, R., Harraz, A. M., Boitrelle, F., Kuroda, S., Hamoda, T. A. A., Zini, A., Ko, E., Calik, G., Toprak, T., Kandil, H., Gül, M., Bakırcıoğlu, M. E., Parekh, N., Russo, G. I., Tadros, N., … Global Andrology Forum (2023). Consensus and diversity in the management of varicocele for male infertility: Results of a global practice survey and comparison with guidelines and recommendations. The World Journal of Men's Health, 41(1), 164–197.

Stojanov, M., Baud, D., Greub, G., & Vulliemoz, N. (2018). Male infertility: The intracellular bacterial hypothesis. New Microbes and New Infections, 26, 37–41.

Tvrdá, E., Ďuračka, M., Benko, F., & Lukáč, N. (2022). Bacteriospermia – a formidable player in male subfertility. Open Life Sciences, 17(1), 1001–1029.

Wang, S., Zhang, K., Yao, Y., Li, J., & Deng, S. (2021). Bacterial infections affect male fertility: A focus on the oxidative stress-autophagy axis. Frontiers in Cell and Developmental Biology, 9, 727812.