Infections and Infertility

  • Durwood E. NealJr.


Genitourinary tract infections and other inflammatory conditions are known contributors to male-factor infertility.1,2 Their effects are still not entirely understood, but there are strong associations. Because male-factor infertility accounts for 30% to 50% of infertility cases,3 and genitourinary infections are ubiquitous, these associations are of great interest. Because these infections are both preventable and treatable, much study has been done in this field. Unfortunately, there is a paucity of confirmatory data on the etiology of the process and treatment efficacy. The difficulty in most of the research on the association between infection and infertility has been in proving the presence of a causal agent. Thus, it is problematic to assess the efficacy of any given treatment modality. In females, there is little doubt that early, aggressive antibiotic therapy is beneficial in preventing secondary tubular damage due to pelvic inflammatory disease.4 Furthermore, localized infections in the vagina are known to limit fertility, and aggressive, curative treatment is beneficial to fertility rates.5 The low incidence of symptoms and physical findings in the male proves to be daunting in the evaluation of treatment. When there is an absence of a proven causative organism, the results of any treatment may not be evaluable. When the final common pathway is pregnancy and the semen analysis is usually not definitive, one may be dealing simply with probabilities. It may be best to divide this discussion into infections versus noninfections; however, the line between these two is frequently indistinct.


Chlamydia Trachomatis Pelvic Inflammatory Disease Male Infertility Ureaplasma Urealyticum Chronic Bacterial Prostatitis 
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© Springer Science+Business Media New York 1997

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  • Durwood E. NealJr.

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