**Genital Tract Infection as a Cause of Male Infertility**

Nourhan Mesbah and Hosni Khairy Salem

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/62740

#### **Abstract**

Although infection is one of the preventable causes of human infertility, it is always missed or neglected. History of urethral discharge has been reported in about 45% of the black men attending the outpatient clinic with infertility complaint.

Implicated in this aspect is sexually transmitted disease (STD), including chlamydia, gon‐ orrhea, and human immunodeficiency virus (HIV). Nonsymptomatic chronic prostatitis and seminal vesiculitis have been associated with poor semen quality and infertility. In‐ fection may affect male fertility in different ways, including impairment of spermatogen‐ esis, induction of autoimmune mechanisms, obstruction of the ejaculatory ducts, and dysfunction of the ejaculated sperms, decrease in the motility of the spermatozoa, and in‐ duction of reactive oxygen species (ROS).

In this chapter, the following points are discussed: 1. Types of genital tract infections that may cause infertility. 2. Prevalence of infection in infertile males. 3. Mechanism by which genital tract infection can cause infertility. 4. Fertility preservation by early diagnosis and treatment of STD. 5. Future perspectives.

**Keywords:** Infections, Urinary tract infections, Infertility in males, Sexually transmitted diseases, Chlamydia, Gonorrhea

#### **1. Introduction**

Infertility can be defined as a failure to conceive in a couple trying to reproduce for a period of 2 years of constant unprotected sex [1]. Of all sexually active couples, 12–15% is infertile [2]. Male component represents around 50% of the time either in isolation or in combination with a female factor [1, 3]. Infertility can be attributed to many causes. Infectious agents can interfere with the reproductive function in both sexes. Infections of male genital urinary tract account for about 15% of the case of male infertility. Different sites can be affected in the male repro‐ ductive system, such as the testis, epididymis, and male accessory sex glands. Spermatogenesis

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

itself can be affected by urogenital infections at different levels of development, maturation, and transport of spermatozoa. These infections can be both sexually transmitted and nonsexually transmitted. Among the most common microorganisms involved in sexually trans‐ mitted infections, thus interfering with male fertility, are the *Chlamydia trachomatis* and *Neisseria gonorrhea*. Less frequently, male infertility may be due to nonsexually transmitted epididymoorchitis, mostly caused by *Escherichia coli*. Infections of the lower genital tract seem to have little importance. However, such infections, as well as those involving other parts of the male genital urinary tract, may cause a microbial colonization of the semen [4].
