Trichomoniasis in Men: A Neglected Factor in Male Infertility?

Purpose

This study is aimed to detect the frequency of trichomoniasis, a sexually transmitted infection caused by an anaerobic protozoan Trichomonas vaginalis, in men referred to the Fertility and Infertility Research Center Hamadan University of Medical Sciences.

Methods

In this cross-sectional study, a group of 197 male volunteers who sought medical attention for issues related to infertility participated. The urine and semen samples were collected in sterile conditions. Both urine and semen sediment were promptly examined under a microscopy to detect the presence of motile trophozoites. Subsequently, 50 µl of urine sediment were inoculated into the Dorset culture medium, whereas 50 µl of semen sediment were inoculated into the Diamond culture (TYI-S-33) and incubated at 35.5^oC. Finally, the processed urine samples were used for molecular analysis.

Results

The investigated subjects had an average age ranging from 36 to 40 years. There were 181 volunteers with fertility issues, outnumbering the 16 individuals with normal fertility. Spermogram analysis showed that 48% of participants had non-motile or progressive sperms, and 48% had abnormalities in sperm morphology. T. vaginalis was not detected through microscopic assessment, but PCR and sequence analysis revealed one case in a 33-year-old infertile individual, who had only 0.3% normal sperm with 19% motility. The isolated T.vaginalis was found to have the G genotype based on the sequencing analysis.

Conclusion

Trichomoniasis in males was considered unimportant, with the belief that it would improve on its own. This study suggests that parasites can be considered as one of the male infertility factors, however, the impact is not fully understood. This investigation confirmed the effectiveness of molecular techniques in detecting trichomoniasis in males.