BACTERIOSPERMIA AS A DETERMINANT OF MALE INFERTILITY: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.71000/f57t7x64Keywords:
Male infertility, Bacteriospermia, Semen quality, Staphylococcus aureus, Sperm DNA fragmentation, Urogenital infection.Abstract
Background: Male infertility is a significant global health concern, with bacterial infections of the male reproductive tract increasingly implicated as a contributing factor. This study aimed to analyze the prevalence and spectrum of seminal bacterial contamination and its graded association with the severity of male infertility.
Methods: A cross-sectional study was conducted from November 2023 to September 2024 at DHQ Teaching Hospital Timergara. Two hundred (200) infertile male participants were enrolled. Following WHO guidelines, semen samples were collected and analyzed for routine parameters, sperm DNA fragmentation, and bacterial culture. Identification of isolates was performed using the VITEK® 2 system.
Results: Overall, 19.5% (39/200) of semen samples showed significant bacterial growth. A striking dose-response relationship was observed: bacterial positivity increased progressively from 4.4% in men with normal semen parameters to 40.0% in men with severe male factor infertility (p<0.001). Staphylococcus aureus was the predominant isolate (59.0%). Bacterial load demonstrated a strong inverse correlation with key semen parameters, including sperm concentration (r=-0.78), total motility (r=-0.82), and vitality (r=-0.85), and a positive correlation with sperm DNA fragmentation index (r=+0.88). Multivariable analysis identified bacteriospermia as a strong independent predictor of infertility (Adjusted OR=3.85; 95% CI: 1.98-7.49), accounting for 28.6% of the population-attributable risk. Furthermore, 71.8% of treated cases showed improvement in semen parameters, while untreated cases demonstrated progressive deterioration over six months.
Conclusion: Seminal bacterial contamination demonstrates a strong, graded association with the severity of male infertility, with Staphylococcus aureus as the key pathogen. The correlation with impaired sperm quality and DNA integrity, coupled with the reversibility upon treatment, underscores bacteriospermia as a significant, modifiable factor in male infertility management.
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