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Infections in the Infertile Couple, Iceberg’s Tip

Date: (16/10/2009)

Facultad de Medicina

Since 15 years ago, the marital infertility by no apparent cause in the Laboratory of Pathology of the UANL School of Medicine.

Histopathologic test of the uterine curettage's material for chlamydia.

By Mayra Silva Almanza

The first approach of this research –which is carried out in the Laboratory of Andrology and the Department of Pathology Cellular Biology section- was focused on men, in other words, in all alterations that can depend on congenital, environmental, genetic or any other defects that impact in spermatozoid’s reproduction and quality.

Doctor in Medicine and Andrology, Maria Guadalupe Gallegos Avila, a leader in this field, explains how they analyzed infertile men’s biopsy, suggesting some diagrams of pathologies’ classification which could be the cause of the infertility.

In a first stage, this idea comes up from Doctor Gallegos’ Specialty in Morphology and School of Medicine’s technology establishment support. “Since 80’s we had an electronic microscope and procedure laboratory. We are working in infertile men’s seminal liquid Electronic Microscopy.

This project’s results were showed in the Universidad Autonoma de Madrid as Gallegos Avila’s Doctorate in Medicine thesis, receiving Suma Cum Laude distinction.

“The conclusion was that 90 percent or even more of the marital infertility cases of unknown cause involves the infectious factor of the fertility that recently was ignored or underestimated.
In most of the cases -70 percent of infertile couples- we do not know the cause and there is where we find a infectious factor.”

“We also identify what microbiological organisms cause the infertility in that couple group; basically, they are two bacterial prototypes, the Chlamydia trachomatis (from serotypes D to K, which cause conjunctivitis, pharyngitis and rinosinusitis) and Ureplasma urelyticum, both of them affect men and women.”

Dra. Gallegos also said these problems are ignored, because the infection caused by those germs does not cause a characteristic clinical profile and is unnoticed. “We have concluded that the most common symptoms are testicular pain, vaginal fluid or leucorrhea related to chronic endometritis.”

All of this added to physical or organic involvements of the couple’s infertility, Dra. Gallegos is conscious of sociocultural aspects that increase it.

“For example, most of the times the women are who go to the doctor to make a check-up is part of the culture. Furthermore, routine tests such as the smear test do not identify an infection at all, because it is focused on detecting cervical and uterine cancer.”

The technology used different symptoms and medical ignorance that cannot be avoided, increased the problem. I always thought that what we were observing in marital infertility was not more than iceberg’s peak of the big problem that infections caused by atypical germs represent and it is like that,” said Doctor Guadalupe Gallegos.

Subsequently and thanks to the first results, the research was focusing on clinical pathological correlation, which comes from the andrological clinic development that is focused on sexuality, fertility and the male genital system problems as well as the establishment of a specialized laboratory for spermatology and seminology.

The last scientific contributions are a postitive consequence of Dra. Gallegos' working group and said that coincidentally with mobility, morphology, life and extra lifetime of the spermatozoid’s affection, there is a genetic and chromosome damage in spermatozoids caused by the bacteria.

The internal genital infection is very important because it can identify not only the time for procreating but quality or embryonic health affection, because the damage can be avoided and it is not heritable.

Gallegos Avila described: “The spermatozoids get damaged in some place of the male genital system; it can be the spididymis, a sack located on the testicle, in the blister of the efferent duct or in the seminal vesicles which house spermatozoids before they are taken to outside with the seminal liquid.”

“Women’s affected organs by the bacteria are: the neck of the uterus, endometrium (the inner cover of the uterus), oviducts or uterine tubes, ovaries and the pelvic cavity. They create a inhospitable environment for the spermatozoid, ovary and embryo, so, the lack of procreation by infection is measured by multiple factors which are difficult to understand.”

That is why the infertile couple is treated –empirically- for resolving the lack of procreation through artificial insemination. Without considering the intrauterine and sperm infection, only 30 or 40 percent work.

“Clean, perfumed and selected spermatozoids of the best representatives get in a polluted environment. The same process is for the embryo, it does not matter if it was created by in vitro fertilization, which is so expensive and is just 30 percent successfully.”

We invite you to read the second part of this article: A Culture and Education Problem, Chlamydia trachomatis and Ureplasma urealyticum.