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Elastase as an indicator of silent genital tract infection in infertile men
Abstract:
Due to the absence of clinical symptoms, silent genital tract inflammation can be diagnosed only by laboratory tests. In this study we have evaluated seminal plasma elastase levels, using an immunoabsorbent assay, in a group of 84 infertile men. Seminal plasma levels of elastase were correlated with the number of white blood cells in the ejaculate, the number of peroxidase-positive leucocytes and with sperm culture. A high number of leucocytes (greater than 10) and a significantly higher number of men with peroxidase-stained leucocytes exceeding 10(6)/ml was found in a group of men with elastase levels greater than 250 ng/ml. There was a significant correlation between sperm culture results and elastase levels, most men with negative sperm culture having a lower seminal plasma elastase level. Following the treatment with antibiotics of men with an elevated elastase level, sperm parameters improved in 67% of those in whom elastase levels were lowered after treatment. In those men with persisting elevated levels of elastase improvement of sperm parameters was found in only 10%. It is concluded that an elevated level of elastase is a sensitive indicator of asymptomatic genital tract infection and that a single determination gives a reliable criterion and relatively exact quantification of infection.
Insights
Silent genital tract infections in infertile men can be detected by measuring seminal plasma elastase levels. Elevated elastase indicates infection and correlates with improved sperm parameters after antibiotic treatment.
Area of Science:
- Reproductive Medicine
- Urology
- Infectious Diseases
Background:
- Asymptomatic genital tract inflammation often goes undiagnosed without laboratory testing.
- Inflammation can negatively impact male fertility.
Purpose of the Study:
- To evaluate seminal plasma elastase levels as a diagnostic marker for asymptomatic genital tract infection in infertile men.
- To correlate elastase levels with semen parameters and infection markers.
- To assess the impact of antibiotic treatment on elastase levels and sperm parameters.
Main Methods:
- Immunoabsorbent assay used to measure seminal plasma elastase in 84 infertile men.
- Correlation analysis performed between elastase levels, white blood cell counts, peroxidase-positive leucocytes, and sperm culture results.
- Semen parameters assessed before and after antibiotic treatment in men with elevated elastase.
Main Results:
- Elevated seminal plasma elastase levels (greater than 250 ng/ml) correlated with higher white blood cell counts and peroxidase-stained leucocytes.
- A significant correlation was found between elastase levels and negative sperm cultures.
- Sperm parameters improved in 67% of men whose elastase levels decreased after antibiotic treatment, compared to only 10% in those with persistent high elastase.
Conclusions:
- Elevated seminal plasma elastase is a sensitive indicator of asymptomatic genital tract infection.
- A single elastase measurement provides a reliable criterion for diagnosing and quantifying genital tract infection.
- Targeted antibiotic treatment based on elastase levels can lead to significant improvements in sperm parameters.
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