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Impact of Mycoplasma hominis on Sperm Quality Among Infertile Men: A Systematic Review and Meta-Analysis
Safa Boujemaa1, Gurparsad Singh Suri2, Gurleen Kaur3
1Biologica Training and Consulting La Marsa Tunis Tunisia.
Background And Aims:
Infections are an important cause of male infertility, yet the effects of Mycoplasma hominis on specific semen parameters remain unclear. In this meta-analysis, we evaluated the impact of M. hominis infection on sperm quality.
Methods:
Comprehensive searches were performed in PubMed, Embase, Web of Science, Scopus, the Cochrane Library, Google Scholar, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from their inception through October 2025. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated. Egger's regression test and examination of funnel plots were applied to evaluate potential publication bias. Subgroup and meta-regression analyses were carried out to identify possible sources of heterogeneity, and sensitivity analysis was performed to verify the robustness of the overall estimates.
Results:
Across 11 eligible studies, our analyses demonstrated that infertile men harboring M. hominis presented significantly lower sperm concentration (SMD = -0.815; 95% CI: -1.314 to -0.317; p = 0.001), progressive motility (SMD = -0.360; 95% CI: -0.683 to -0.037; p = 0.03), sperm viability (SMD = -0.831; 95% CI: -1.410 to -0.253; p = 0.005), and normal morphology (SMD = -0.631; 95% CI: -1.178 to -0.083; p = 0.02) compared to uninfected patients. Conversely, seminal fluid pH was consistently higher among infected subjects (SMD = 0.586; 95% CI: 0.167 to 1.006; p = 0.006). Subgroup and meta-regression analysis suggested that study geographic location and diagnostic technique contributed to the observed heterogeneity. However, no statistically significant publication bias was detected based on Egger's test (p = 0.10), and sensitivity analysis confirmed the robustness of the results.
Conclusion:
Collectively, these findings support a potential relationship between M. hominis infection and deteriorated semen quality. More rigorously designed prospective studies are needed to clarify causality and enhance diagnostic guidelines.
Insights
Mycoplasma hominis infection is linked to reduced sperm concentration, motility, viability, and normal morphology in infertile men. This meta-analysis highlights a significant association between M. hominis and impaired sperm quality, suggesting a need for further research.
Area of Science:
- Reproductive Medicine
- Microbiology
- Infectious Diseases
Background:
- Male infertility affects a significant portion of couples trying to conceive.
- Infections, particularly those caused by bacteria like Mycoplasma hominis, are recognized as a contributing factor to male infertility.
- The precise impact of Mycoplasma hominis on specific semen parameters requires further clarification.
Purpose of the Study:
- To conduct a meta-analysis evaluating the impact of Mycoplasma hominis infection on sperm quality in infertile men.
- To synthesize existing evidence regarding the relationship between M. hominis and various semen parameters.
Main Methods:
- A comprehensive literature search was performed across multiple databases (PubMed, Embase, Web of Science, Scopus, Cochrane Library, Google Scholar, CINAHL) up to October 2025.
- Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated to quantify the effects.
- Publication bias was assessed using Egger's regression test, with subgroup, meta-regression, and sensitivity analyses performed to explore heterogeneity and confirm result robustness.
Main Results:
- The meta-analysis of 11 studies revealed that men with M. hominis infection had significantly lower sperm concentration (SMD = -0.815), progressive motility (SMD = -0.360), viability (SMD = -0.831), and normal morphology (SMD = -0.631) compared to uninfected men.
- Seminal fluid pH was significantly higher in infected subjects (SMD = 0.586).
- Geographic location and diagnostic techniques were identified as sources of heterogeneity, with no significant publication bias detected (p = 0.10).
Conclusions:
- The findings suggest a significant association between Mycoplasma hominis infection and impaired semen quality in infertile men.
- Further rigorously designed prospective studies are warranted to establish causality and inform diagnostic guidelines for male infertility.
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