title: Effect of human papillomavirus and Chlamydia trachomatis co-infection on sperm quality in young heterosexual men with chronic prostatitis-related symptoms.
abstract: OBJECTIVE
  To investigate the effect of human papillomavirus (HPV) and Chlamydia trachomatis (Ct) co-infection on sperm concentration, motility and morphology, in a large cohort of young heterosexual male patients with chronic prostatitis-related symptoms.
  
  
  METHODS
  Patients with chronic prostatitis-related symptoms, attending the same centre for sexually transmitted diseases from January 2005 and December 2010, were consecutively enrolled in this cross-sectional study. All patients underwent clinical and instrumental examination, microbiological cultures for common bacteria, DNA extraction, mucosal and serum antibodies evaluation for Ct, specific tests for HPV and semen analysis. The semen variables analysed were: volume; pH; sperm concentration; motility; and morphology. Subjects were subdivided in two groups: group A, patients with Ct infection alone and group B, patients with Ct and HPV co-infection. The main outcome measurement was the effect of Ct and HPV co-infection on the semen variables examined.
  
  
  RESULTS
  Of 3050 screened patients, 1003 were enrolled (32.9%) in the study. A total of 716 (71.3%) patients were allocated to group A, and 287 (28.7%) to group B. Significant differences between the two groups were reported in terms of percentage of motile sperm (degrees of freedom [df] = 1001; t-test = 11.85; P < 0.001) and percentage of normal morphological forms (df = 1001; t-test = 7.18; P < 0.001), while no differences were reported in terms of semen volume or pH. According to World Health Organization thresholds for normal semen, 364 (50.8%) men in group A and 192 (66.8%) men in group B were subfertile (odds ratio = 1.95; 95% confidence interval 1.46-2.60; P < 0.001). No correlation between HPV genotype, mucosal IgA type and semen variables was found.
  
  
  CONCLUSIONS
  In a population of prostatitis-related symptoms attributable to Ct infection, co-infection with HPV has a significant role in decreasing male fertility, in particular with regard to sperm motility and morphology.
authors.affiliation: Department of Urology, Santa Chiara Regional Hospital, Trento, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Cai
authors.forename: Florian M E
authors.initials: FM
authors.lastname: Wagenlehner
authors.forename: Nicola
authors.initials: N
authors.lastname: Mondaini
authors.forename: Carolina
authors.initials: C
authors.lastname: D'Elia
authors.forename: Francesca
authors.initials: F
authors.lastname: Meacci
authors.forename: Serena
authors.initials: S
authors.lastname: Migno
authors.forename: Gianni
authors.initials: G
authors.lastname: Malossini
authors.forename: Sandra
authors.initials: S
authors.lastname: Mazzoli
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bartoletti
mesh_terms: D000328:Adult; D015153:Blotting, Western; D002690:Chlamydia Infections / Q000150:complications / Q000453:epidemiology / Q000382:microbiology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D002908:Chronic Disease; D060085:Coinfection; D003430:Cross-Sectional Studies; D020010:Heterosexuality; D006801:Humans; D007248:Infertility, Male / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000821:virology; D008297:Male; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology; D011472:Prostatitis / Q000150:complications / Q000453:epidemiology / Q000382:microbiology* / Q000821:virology; D055101:Semen Analysis; D013081:Sperm Motility; D013094:Spermatozoa / Q000382:microbiology / Q000473:pathology / Q000821:virology; D011795:Surveys and Questionnaires
keywords: Chlamydia trachomatis; NIH-CPSI; fertility; human papillomavirus; prostatitis; quality of life