Associations of Ureaplasma urealyticum infection with male infertility and intrauterine insemination outcomes.

Yang-Yang Wan, Xiao-Yun Shi, Wen-Jing Liu, Shun Bai, Xin Chen, Si-Yao Li, Xiao-Hua Jiang, Li-Min Wu, Xian-Sheng Zhang, Juan Hua
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Abstract

Abstract: Ureaplasma urealyticum (UU) is one of the most commonly occurring pathogens associated with genital tract infections in infertile males, but the impact of seminal UU infection in semen on intrauterine insemination (IUI) outcomes is poorly understood. We collected data from 245 infertile couples who underwent IUI at The First Affiliated Hospital of USTC (Hefei, China) between January 2021 and January 2023. The subjects were classified into two groups according to their UU infection status: the UU-positive group and the UU-negative group. We compared semen parameters, pregnancy outcomes, and neonatal birth outcomes to investigate the impact of UU infection on IUI outcomes. There were no significantly statistical differences in various semen parameters, including semen volume, sperm concentration, total and progressive motility, sperm morphology, leukocyte count, the presence of anti-sperm antibody, and sperm DNA fragmentation index (DFI), between the UU-positive and UU-negative groups of male infertile patients (all P > 0.05). However, the high DNA stainability (HDS) status of sperm differed between the UU-positive and UU-negative groups, suggesting that seminal UU infection may affect sperm nuclear maturation (P = 0.04). Additionally, there were no significant differences in pregnancy or neonatal birth outcomes between the two groups (all P > 0.05). These results suggest that IUI remains a viable and cost-effective option for infertile couples with UU infection who are facing infertility issues.

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尿解支原体感染与男性不育症和宫腔内人工授精结果的关系。
摘要:解脲支原体(UU)是与不育男性生殖道感染相关的最常见病原体之一,但人们对精液中UU感染对宫腔内人工授精(IUI)结果的影响知之甚少。我们收集了 2021 年 1 月至 2023 年 1 月期间在中国科学技术大学第一附属医院(中国合肥)接受人工授精的 245 对不育夫妇的数据。根据UU感染情况将受试者分为两组:UU阳性组和UU阴性组。我们比较了精液参数、妊娠结局和新生儿出生结局,以研究 UU 感染对人工授精结局的影响。UU阳性组和UU阴性组男性不育患者的精液参数,包括精液量、精子浓度、总活力和渐进活力、精子形态、白细胞计数、抗精子抗体的存在以及精子DNA碎片指数(DFI),均无明显统计学差异(均P>0.05)。然而,精子的高DNA染色性(HDS)状态在UU阳性组和UU阴性组之间存在差异,这表明精液中的UU感染可能会影响精子的核成熟(P = 0.04)。此外,两组在妊娠和新生儿出生结果方面无明显差异(P>0.05)。这些结果表明,对于面临不孕问题的UU感染不育夫妇来说,人工授精仍然是一种可行且经济有效的选择。
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