[Urogenital infection and male fertility]

There is disagreement as to the influence of urogenital infections on male fertility. The causative organisms are not the same according to different authors and ways in which the sperm are examined do not always seem to have the necessary bacteriological precision. A recent study carried out by us has however shown that Ureaplasma urealyticum and E. coli appear to be the bacteria that are most frequently met in cultures from the semen of infertile men. Changes that these bacteria can bring about are: --direct effects, in that the numbers of spermatozoa themselves are diminished as well as their motility, their morphology and their ability to fertilize. From this point of view the connection between the concentration of bacteria in relationship to the concentration of gametes could be important; --indirect effects, in so far as that infection should change the constituent qualities of the seminal fluid and thus have a secondary effect on spermatozoa, as for example the presence of large numbers of polynuclear cells or the formation of antisperm antibodies. Therapeutic trials, which could have helped solve the problem, do not yet seem to have been decisive. But considerable variations in sperm parameters, which by themselves can perhaps affect the antibacterial potency of seminal fluid, could explain why there are variations in success and failure. Finally, emphasis is placed on the need to stick to rigorous bacteriological protocols and to undertake at the same time well codified clinical, biological, epidemiological and experimental studies.