The Relationship Between Ureaplasma Species and Male Infertility: Pathogenicity, Biology, Diagnosis, and Treatment

Area of Science:

• Reproductive Medicine
• Microbiology
• Urology

Background:

• Ureaplasma spp. are common human-associated mycoplasmas, with two main species: Ureaplasma urealyticum (UUR) and Ureaplasma parvum (UPA).
• The role of Ureaplasma spp. as a cause of male infertility is debated, with more evidence linking UUR to fertility issues than UPA.
• Recent years have seen increased research into the connection between Ureaplasma spp. and male infertility.

Purpose of the Study:

• To clarify the relationship between Ureaplasma species and male infertility.
• To review the evidence supporting Ureaplasma spp.'s causal role in infertility.
• To evaluate diagnostic methods, antimicrobial susceptibility, and therapeutic options for ureaplasmal infections in infertile males.

Main Methods:

• Review of studies published over the last 30 years investigating Ureaplasma spp. and male infertility.
• Examination of Ureaplasma spp. biology, including growth, biovars, and transmission.
• Evaluation of diagnostic techniques, antibiotic resistance patterns, and treatment strategies.

Main Results:

• Both Ureaplasma parvum (UPA) and Ureaplasma urealyticum (UUR) can impair semen motility.
• Key risk factors for male infertility associated with Ureaplasma include the specific species, patient's sexual history, number of partners, bacterial load, and antimicrobial resistance.
• Doxycycline is identified as the primary antibiotic treatment for ureaplasmal infections.

Conclusions:

• Ureaplasma spp. are not merely passive bystanders but can be active contributors to infertility.
• These bacteria represent an underestimated factor in human reproduction.
• Ureaplasma spp. can be considered an etiological agent in cases of unexplained male infertility and serve as a valuable diagnostic marker.