Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1993 Jul;83(7):996–1001. doi: 10.2105/ajph.83.7.996

The relationship of Chlamydia trachomatis infection and male infertility.

G A Greendale 1, S T Haas 1, K Holbrook 1, B Walsh 1, J Schachter 1, R S Phillips 1
PMCID: PMC1694769  PMID: 8328623

Abstract

OBJECTIVES. Infertility affects at least 2 million couples in the United States. One third of infertility is attributed to male causes, but the etiology of most male infertility remains obscure. This study was designed to investigate the relationship between Chlamydia trachomatis and unexplained infertility in men. METHODS. Questionnaires and serum were collected prospectively from 52 case subjects (men from couples with explicitly defined idiopathic infertility) and 79 control subjects (first-time expectant fathers). RESULTS. Case subjects were significantly more likely than control subjects to be seropositive for antibody to C trachomatis at a titer of 1:64 or higher. By test of trend, higher titers were associated with higher odds ratios. Adjustment for age of either partner at initiation of pregnancy attempt, race, income, previous genitourinary symptoms or diagnoses, number of previous sexual partners, and barrier contraceptive use had no significant effect on the estimate of the odds ratio. One half of the men who were antibody positive had no history of genitourinary symptoms. CONCLUSIONS. Our results suggest an association between infection with C trachomatis in men and unexplained infertility and imply that infection is frequently asymptomatic.

Full text

PDF
996

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Auroux M. R., De Mouy D. M., Acar J. F. Male fertility and positive Chlamydial serology. A study of 61 fertile and 82 subfertile men. J Androl. 1987 May-Jun;8(3):197–200. doi: 10.1002/j.1939-4640.1987.tb02431.x. [DOI] [PubMed] [Google Scholar]
  2. Cates W., Jr Sexually transmitted organisms and infertility: the proof of the pudding. Sex Transm Dis. 1984 Apr-Jun;11(2):113–116. [PubMed] [Google Scholar]
  3. Cates W., Jr, Wasserheit J. N. Genital chlamydial infections: epidemiology and reproductive sequelae. Am J Obstet Gynecol. 1991 Jun;164(6 Pt 2):1771–1781. doi: 10.1016/0002-9378(91)90559-a. [DOI] [PubMed] [Google Scholar]
  4. Chow J. M., Yonekura M. L., Richwald G. A., Greenland S., Sweet R. L., Schachter J. The association between Chlamydia trachomatis and ectopic pregnancy. A matched-pair, case-control study. JAMA. 1990 Jun 20;263(23):3164–3167. [PubMed] [Google Scholar]
  5. Collins J. A., Rowe T. C. Age of the female partner is a prognostic factor in prolonged unexplained infertility: a multicenter study. Fertil Steril. 1989 Jul;52(1):15–20. doi: 10.1016/s0015-0282(16)60781-1. [DOI] [PubMed] [Google Scholar]
  6. Collins J. A., Wrixon W., Janes L. B., Wilson E. H. Treatment-independent pregnancy among infertile couples. N Engl J Med. 1983 Nov 17;309(20):1201–1206. doi: 10.1056/NEJM198311173092001. [DOI] [PubMed] [Google Scholar]
  7. Gibson M., Gump D., Ashikaga T., Hall B. Patterns of adnexal inflammatory damage: Chlamydia, the intrauterine device, and history of pelvic inflammatory disease. Fertil Steril. 1984 Jan;41(1):47–51. doi: 10.1016/s0015-0282(16)47539-4. [DOI] [PubMed] [Google Scholar]
  8. Gregoriou O., Vitoratos N., Papadias C., Gregoriou G., Zourlas P. A. The role of chlamydial serology in fertile and subfertile men. Eur J Obstet Gynecol Reprod Biol. 1989 Jan;30(1):53–58. doi: 10.1016/0028-2243(89)90093-2. [DOI] [PubMed] [Google Scholar]
  9. Gump D. W., Gibson M., Ashikaga T. Evidence of prior pelvic inflammatory disease and its relationship to Chlamydia trachomatis antibody and intrauterine contraceptive device use in infertile women. Am J Obstet Gynecol. 1983 May 15;146(2):153–159. doi: 10.1016/0002-9378(83)91044-x. [DOI] [PubMed] [Google Scholar]
  10. Hellstrom W. J., Schachter J., Sweet R. L., McClure R. D. Is there a role for Chlamydia trachomatis and genital mycoplasma in male infertility? Fertil Steril. 1987 Aug;48(2):337–339. doi: 10.1016/s0015-0282(16)59370-4. [DOI] [PubMed] [Google Scholar]
  11. Meares E. M., Jr Prostatitis syndromes: new perspectives about old woes. J Urol. 1980 Feb;123(2):141–147. doi: 10.1016/s0022-5347(17)55828-0. [DOI] [PubMed] [Google Scholar]
  12. Mickey R. M., Greenland S. The impact of confounder selection criteria on effect estimation. Am J Epidemiol. 1989 Jan;129(1):125–137. doi: 10.1093/oxfordjournals.aje.a115101. [DOI] [PubMed] [Google Scholar]
  13. Nettleman M. D., Jones R. B., Roberts S. D., Katz B. P., Washington A. E., Dittus R. S., Quinn T. S. Cost-effectiveness of culturing for Chlamydia trachomatis. A study in a clinic for sexually transmitted diseases. Ann Intern Med. 1986 Aug;105(2):189–196. doi: 10.7326/0003-4819-105-2-189. [DOI] [PubMed] [Google Scholar]
  14. Paavonen J. Chlamydia trachomatis in acute salpingitis. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):957–959. doi: 10.1016/0002-9378(80)91086-8. [DOI] [PubMed] [Google Scholar]
  15. Swerdloff R. S., Overstreet J. W., Sokol R. Z., Rajfer J. UCLA conference. Infertility in the male. Ann Intern Med. 1985 Dec;103(6 ):906–919. doi: 10.7326/0003-4819-103-6-906. [DOI] [PubMed] [Google Scholar]
  16. Thompson S. E., Washington A. E. Epidemiology of sexually transmitted Chlamydia trachomatis infections. Epidemiol Rev. 1983;5:96–123. doi: 10.1093/oxfordjournals.epirev.a036266. [DOI] [PubMed] [Google Scholar]
  17. Walters M. D., Eddy C. A., Gibbs R. S., Schachter J., Holden A. E., Pauerstein C. J. Antibodies to Chlamydia trachomatis and risk for tubal pregnancy. Am J Obstet Gynecol. 1988 Oct;159(4):942–946. doi: 10.1016/s0002-9378(88)80177-7. [DOI] [PubMed] [Google Scholar]
  18. Wang S. P., Grayston J. T., Alexander E. R., Holmes K. K. Simplified microimmunofluorescence test with trachoma-lymphogranuloma venereum (Chlamydia trachomatis) antigens for use as a screening test for antibody. J Clin Microbiol. 1975 Mar;1(3):250–255. doi: 10.1128/jcm.1.3.250-255.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES