Published: 2021-04-23

The relationship between male factor infertility and Chlamydia infection, still an undecided issue

Shakeela Ishrat, Marufa Hossain, Shirin Jahan, Sohely Nazneen, Fahmida Chowdhury, Satu Farhana Karim


Background: Seropositivity of Chlamydia trachomatis in men is suggestive of chronic and recurrent infection with this sexually transmitted organism. Most males with urogenital Chlamydia infection have serum immunoglobulin G (IgG) antibodies to C. trachomatis that persist for years. Serologic studies linking C. trachomatis to male infertility and sperm quality lead to highly variable results. The objective of the study was to examine the effect of Chlamydia infection, as determined by Chlamydia seropositivity on semen quality.

Methods: One hundred men having semen analysis as part of infertility work up had anti-Chlamydia antibody test. They were grouped into those who are seropositive for Chlamydia antibody IgG and those who were not. The sperm parameters and prevalence of different semen abnormalities were compared between the two groups, Chlamydia positive and Chlamydia negative.

Results: There are no significant difference in semen parameters and prevalence of different semen abnormalities between the two groups. The sonographical finding of epididymal cyst is 45.8% in Chlamydia positive compared to 12.2% in Chlamydia negative; the difference is significant.

Conclusions: Seropositivity of Chlamydia infection in infertile male is not predictive of semen abnormalities. Serological screening of the male partner for Chlamydia trachomatis provides no more benefit than identifying the female partner at risk of tubal factor infertility and males at risk of epididymal obstruction.


Male factor infertility, Semen parameters, Chlamydia trachomatis, Chlamydia seropositivity

Full Text:



Hosseinzadeh S, Eley A, Pacey AA. Semen Quality of Men With Asymptomatic Chlamydial Infection. J of Androl. 2004;25(1):104-9.

Tohidpour M, Shahhosseiny M, Mehrabian S, Saremi A. Prevalence of Chlamydia trachomatis and Listeria monocytogenes in Infertile Men and the Effect on Semen Parameters. Jundishapur J Microbiol. 2020;13(6):e97780.

Ochsendorf FR. Sexually transmitted infections: impact on male fertility. Andrologia. 2008;40:72-5.

Baud D, Pattaroni C, Vulliemoz N, Castella V, Marsland BJ, Stojanov M. Sperm Microbiota and Its Impact on Semen Parameters. Front Microbiol. 2019;10:234.

Gimenes F, Souza RP, Bento JC, Teixeira JJV, Maria-Engler SS, Bonini MG, Consolaro MEL. Male infertility: a public health issue caused by sexually transmitted pathogens. Nat Rev Urol. 2014;11:672-87.

Greendale GA, Haas ST, Holbrook K, Walsh B, Schachter J, Russell S, Phillips RS. The Relationship of Chlamydia trachomatis Infection and Male Infertility. Am J of Public Health. 1993;83(7):997-1001.

Veznik Z, Pospisil L, Svecova D, Zajicova A, Unzeitig V. Chlamydiae in the ejaculate: their influence in the quality and morphology of the sperm. Acta Obstet Gynecol Scand. 2004;83:656-60.

Hamdad-Daoudi F, Petit J, Eb F. Assessment of Chlamydia trachomatis infection in asymptomatic male partners of infertile couples. J Med Microbiol. 2004;53:985-90.

Joki-Korpela P, Sahrakorpi N, Halttunen M, Surcel HM, Paavonen J, Tiitinen A, et al. The role of Chlamydia trachomatis infection in male infertility. Fertil Steril. 2009;91(4):1448-50.

Redgrove KA, McLaughlin EA. The role of the immune response in Chlamydia trachomatis infection of the male genital tract: a double-edged sword. Front Immunol. 2014;5:1-22.

Gallegos G, Ramos B, Santiso R, Goyanes V, Gosalvez J, Fernandez JL. Sperm DNA fragmentation in infertile men with genitourinary infection by Chlamydia trachomatis and Mycoplasma. Fertil Steril. 2008;9:328-34.

Mazzoli S, Cai T, Addonisio P, Bechi A, Mondaini N, Bartoletti R. Chlamydia trachomatis Infection Is Related to Poor Semen Quality in Young Prostatitis Patients. Eur Urol. 2010;5:708-14.

Al-Sweih NA, Al-fadli AH, Omu AE, Rotimi VO. Prevalence of Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, and Ureaplasma urealyticum Infections and Seminal Quality in Infertile and Fertile Men in Kuwait. J Androl. 2012;33(6):1323-9.

Dohlea GR, Colpib GM, Hargreavec TB, Papp GK, Jungwirthe A, Weidnerf W. The EAU Working Group on Male Infertility EAU Guidelines on Male Infertility. Eur Urol. 2005;48:703-11.