**6. Bacterial infection of the ejaculate**

of their genes cause mosaic ciliopathy, such as asthenozoospermia and anosmia, or asthenozoospermia and swelling of the nasopharyngeal mucosa, which we identified in our patients. The development of ICSI allowed men with pronounced asthenozoospermia, including forms with genetic causes, to have children. The consequences of using ICSI in PCD and DSF are poorly understood because the disorders are rare and only few live births after ICSI have been reported (20 cases according to PubMed). PCD patients with andrological symptoms naturally had no offspring before the advent of ICSI. PCD is an autosomal recessive disorder and is expressed only in homozygotes and compound heterozygotes, when both alleles of one gene are affected. This circumstance reduces PCD risk in ICSI offspring, but makes it more likely for the mutations to accumulate in the population and to occur in homozygote at a higher rate in the long term.

Virus capsids morphologically identical to capsids of *Herpesviridae* family were detected in the nucleus and cytoplasmic droplet of infected spermatozoa by TEM (**Figure 8a**, **b**) (for the review see [99]). The structures shown in **Figure 8** (**8a**, **b**) are capsids of herpes simplex virus

**Figure 8.** (a) Longitudinal section of normal sperm; (b) section through the middle piece of the tail of sperm. VC, HSV capsids; M, mitochondria; A, acrosome; CH, chromatin; and C, centriole. The hexagonal structure of some capsids is visible. Phase-contrast microscopy (c) and IF (d) of infected sperm. HSV antigen (arrows) and DAPI stain for DNA

(blue); (e) FISH with probes to DNA of HSV. Localization of HSV DNA in sperm heads (arrows).

**5. Virus infection of spermatozoa**

88 Spermatozoa - Facts and Perspectives

Bacterial colonies were detected in ejaculate samples from patients with fertility disorders. In the colonies, heteromorphic microorganisms were held together in a diffusive substance, probably of a polysaccharide nature, or covered with membranes as bacterial biofilms. The

**Figure 9.** (a) Bacterial microcolony (B) attached to sperm head (H). (c) Bacterial microcolony (B) attached to sperm tail (T). (b, d) Bacterial microcolonies attached to the epithelial cells (EC). A diffuse substance (a–c) or membranes (Me) (d) are detected between bacterial cells.

majority of microcolonies were attached to squamous epithelial cells, whereas some were associated with sperm heads or tails (**Figure 9a**–**d**).

**Author details**

Elizaveta E. Bragina1

**References**

\* and Elena N. Bocharova2

2 Moscow Scientific and Practical Center of Dermatology, Moscow, Russia

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1 Department of Electron Microscopy, AN Belozersky Institute of Physico-Chemical Biology,

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Moretti et al. [101] examined ejaculate samples from infertile patients and detected *Enteroccocus faecalis* and *Escherichia coli* most frequently and, at lower frequencies, *Streptococcus agalactiae*, *Ureaplasma urealyticum*, *Staphylococcus epidermidis*, *Streptococcus anginosus*, and *Morganella morganii*. With the exception of *U. urealyticum*, the microorganisms are classed with the nonspecific saprophytic microflora and are not addressed in a conventional testing of infertility patients.

Bacteria may damage spermatozoa even in the absence of an overt inflammatory reaction. We observed higher contents of acrosome-reacted spermatozoa (i.e., those with a premature acrosomal reaction) in the ejaculate samples that contained bacterial microcolonies [55].
