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4 May 2004
Chlamydia Also A Problem For Men's Fertility
by George Atkinson

Chlamydia infection in women has been known to be linked to infertility, but Swedish research published in the European journal Human Reproduction has found evidence that infection in men can also lessen the chance of their partners becoming pregnant.

A team from UmeŚ University Hospital in UmeŚ and the Scandinavian Fertility Center in Gothenburg, found decreased pregnancy rates in couples where the man had IgG antibodies - a marker of previous or persistent infection by Chlamydia trachomatis, one of the most common sexually transmitted diseases.

"As anticipated, we found a raised prevalence of Chlamydia trachomatis IgG antibodies in the infertile population compared with the proven fertile population. Importantly, as well as the expected finding of antibodies among the female partners we found that antibodies in the male partner was significantly inversely correlated to the overall pregnancy rate.

The chance of achieving a pregnancy was reduced by 33% if the man was IgG positive," said Associate Professor Jan Olofsson, head of the research team. "Our findings show that it is not only women that need to be concerned about contracting Chlamydia. Men need to be aware that this is potentially serious for them as well."

Antibodies in the women were related to tubal factor infertility (TFI) - confirming previous findings that Chlamydia is linked to TFI. But, IgG antibodies in men were not associated with TFI in their partners.

"As there was no connection between IgG antibodies in the men and TFI in their partners there may be alternative or additional mechanisms involved that are reducing fertility. It is possible that decreased sperm motility or concurrent or undetected infection may play a role, but that is speculative as we did not look at these possibilities in the present study," Professor Olofsson said. But, he added, a follow up study on semen analyses was nearing completion.

There was one reassuring finding from the present study. Principal author Dr Annika Idahl said that for those couples attending the fertility clinic who became pregnant, either spontaneously or through IVF, infection or Chlamydia antibodies did not put the pregnancy at risk as there was no difference in the outcome of the pregnancies between IgG positive or negative couples.

The finding that infection or the presence of Chlamydia antibodies in the infertile men is linked to reduced fertility has lead researchers to suggest screening of both partners who attend infertility clinics. "We suggest that Chlamydia antibody testing of both male and female partners should be included in routine infertility work-up in order to enable a more adequate prognosis for the likelihood of spontaneous pregnancy. But, it remains to be seen in a randomized controlled study whether or not antibiotic treatment either for antibody positive infertile patients or for all infertile patients will increase the chances of pregnancy," said Dr Idahl.

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