Evaluation of the role of Chlamydia trachomatis in primary male infertility

Aims This study aimed to find out the potential role of Chlamydia trachomatis (C. trachomatis) in male primary infertility and to recommend an easy, rapid, and sensitive diagnostic tool for its detection. Methods Semen samples were collected from male patients who presented with primary infertility and from age-matched healthy controls. These samples were analysed according to the World Health Organization guidelines. Infection with C. trachomatis in those patients and controls was detected by two methods; assay of anti-chlamydia IgA antibodies level in seminal plasma and detection C. trachomatis deoxyribonucleic acid (DNA) by real-time polymerase chain reaction (RT-PCR) technology. Results Positive detection of anti-Chlamydia IgA antibody was found in 28 (14%) patients and in 6 (9.2%) controls. Positive detection of C. trachomatis-cryptic plasmid gene was found in 15 (7.5%) patients and in zero of controls. Detection of anti-chlamydia IgA by enzyme-linked immunosorbent assay (ELISA) has a sensitivity of 100% and specificity of 92.97%. There were significant associations between C. trachomatis infection and asthenozoospermia (P = .05), and abnormal vitality (P = .003). Conclusion C. trachomatis infection adversely affects the fertility potential in males because of its effect on the motility and vitality of sperms. We can rely on the detection of anti-chlamydia IgA antibodies in seminal plasma as a rapid sensitive diagnostic test for the detection of C. trachomatis infection.