[The role of the microbial factor in the pathogenesis of male infertility]

Microorganisms can be isolated from most seminal fluid samples, but the significance of bacteriospermia is uncertain because many males lack symptoms associated with the bacterial infection of the reproductive tract. The data on the influence of urogenital tract infections of fertility are contradictory. In many cases opportunistic microorganisms cause such classical infections of the urogenital tract as epididymitis and prostatitis, as well as subclinical reproductive tract infections. Some possible pathophysiological mechanisms of the development of infertility linked with infection of the ejaculate are considered: its direct effect on the fertile properties of the seminal fluid due to a decrease in the number of spermatozoa, the suppression of their motility, changes in their morphology and fertilizing capacity, its indirect influence due to the inhibition of spermatogenesis resulting from testicular damage, autoimmune processes induced by inflammation, secretory dysfunction of the male accessory sex glands as a consequence of the infection of the reproductive tract organs, leukocytospermia with its secondary influence of the ejaculate parameters, etc. The importance of the pathogenic properties of microorganisms for the localization of the inflammatory process in the urogenital tract of males and their role in the pathogenesis of male infertility are discussed.