title: Infectious Burden and Semen Parameters.
abstract: OBJECTIVE
  To investigate the relationship between chronic infections detected in serum and semen quality. The pathogen burden is a concept consisting in the observation that, in patients with heart disease, damaging effects of the coronary arteries increase concomitantly with the number of agents responsible for chronic infections to which patients mounted a serological response. Previous observations that Helicobacter pylori infection may reduce the semen quality prompted us to perform the present study.
  
  
  METHODS
  Blood and semen samples were collected from 73 selected men, enrolled from January 2014 to January 2015. Semen characteristics were evaluated by light and transmission electron microscopy. Transmission electron microscopy data were quantified with a mathematical formula providing numerical scores, such as fertility index (FI, number of sperm free from ultrastructural defects) and the percentages of sperm apoptosis, immaturity, and necrosis. Serum samples were examined by enzyme-linked immunosorbent assay for the presence of immunoglobulin G to the most common agents of chronic infections such as H. pylori (HP), Mycoplasma pneumoniae (MP), Chlamydophila pneumoniae (CP), Epstein-Barr virus (EBV), herpes simplex virus 1 (HSV-1), and cytomegalovirus (CMV).
  
  
  RESULTS
  The prevalence of infections was as follows: HP 43.8%, CP 46.6%, MP 72.6%, EBV 95.9%, HSV-1 74.0%, and CMV 46.6%. Concomitantly with the increased number of pathogens against which the patients mounted a significant antibody response, sperm concentration (P <.05), sperm motility (P <.001), and fertility index (P <.001) were significantly reduced and the percentage of necrotic sperm was increased (P <.01).
  
  
  CONCLUSIONS
  The higher the number of pathogens stimulating an immunoglobulin G systemic response, the lower was the semen quality.
authors: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy. Electronic address: elena.moretti@unisi.it.
authors: Elena
authors: E
authors: Moretti
authors: Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy.
authors: Natale
authors: N
authors: Figura
authors: Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy.
authors: Maria Stella
authors: MS
authors: Campagna
authors: Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Rome, Italy.
authors: Francesca
authors: F
authors: Iacoponi
authors: Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy.
authors: Stefano
authors: S
authors: Gonnelli
authors: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors: Giulia
authors: G
authors: Collodel
mesh_terms: D000328:Adult; D023521:Chlamydophila Infections / Q000453:epidemiology; D016993:Chlamydophila pneumoniae; D002908:Chronic Disease; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology; D016481:Helicobacter Infections / Q000453:epidemiology; D006561:Herpes Simplex / Q000453:epidemiology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007239:Infections / Q000453:epidemiology*; D007248:Infertility, Male / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011019:Pneumonia, Mycoplasma / Q000453:epidemiology; D055101:Semen Analysis; D013094:Spermatozoa / Q000473:pathology / Q000502:physiology; D014777:Virus Diseases / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D007074:Immunoglobulin G