Investigating Chlamydia trachomatis and Genital Mycoplasma Prevalence and Apoptosis Markers in Infertile and Fertile Couples

Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis are common sexually transmitted microorganisms. The aim of the study was to determine the prevalence of these microorganisms in infertile couples and the effect of these infections on semen parameters. In this case-control study, samples were collected from 50 infertile couples and 50 fertile women and men. Specimens were examined for the presence of C. trachomatis, M. hominis, and U. urealyticum by culture and PCR. Semen specimens were analyzed for apoptotic markers using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay and Western blot. In this study, out of 50 semen specimens from infertile men, U. urealyticum and M. hominis were detected in 14 (28%) and 11 (22%) specimens by PCR, and five (10%) and one (2%) specimens by culture, respectively. C. trachomatis was found in five (10%) samples by PCR. In addition, out of 50 endocervical swabs from infertile women, C. trachomatis was found in seven (14%) specimens by PCR, U. urealyticum and M. hominis were detected in 25 (50%) and four (8%) swabs by PCR, and 13 (26%) and two (4%) by culture, respectively. The Western blot and TUNEL assay demonstrated a significant increase in caspase-3 activation and DNA fragmentation in the semen samples of the infected infertile men compared to uninfected men (6 vs. 1.5; P < 0.05). The results demonstrated that C. trachomatis and genital Mycoplasma are widespread among infertile couples, and these infections may lead to decreased semen quality.