Volume 15, Issue 12 (12-2017)
IJRM 2017, 15(12): 763-770 |
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Amin Khoshakhlagh1 
, Reza Salman Yazdi * 2, Farah taj Navab-Akbar3 , Azadeh Ghaheri4 , Shaghayegh Sadeghinia5 , Farid Dadkhah6
, Reza Salman Yazdi * 2, Farah taj Navab-Akbar3 , Azadeh Ghaheri4 , Shaghayegh Sadeghinia5 , Farid Dadkhah6
1- Department of Microbiology, Islamic Azad University, Naein Branch, Isfahan, Iran
2- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. , r.salmanyazdi@royaninstitute.org
3- Department of Microbiology and Virology, Isfahan University of Medical Sciences, Isfahan, Iran.
4- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
5- Department of Biomolecular and Biomedical Science, School of Health Life and Science, Glasgow Caledonian University, Glasgow, UK
6- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
2- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. , r.salmanyazdi@royaninstitute.org
3- Department of Microbiology and Virology, Isfahan University of Medical Sciences, Isfahan, Iran.
4- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
5- Department of Biomolecular and Biomedical Science, School of Health Life and Science, Glasgow Caledonian University, Glasgow, UK
6- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
Abstract: (3031 Views)
Background: Chlamydia trachomatis (CT) with damaging effects on sperm quality parameters can often cause infertility in men.
Objective: The main objective of this study was to determine the diagnostic value of polymerase chain reaction (PCR) and enzyme linked immuno sorbent assay (ELISA) for screening and detecting CT in semen samples of infertile men.
Materials and Methods: In this cross-sectional study, 465 men referring to the clinical laboratory of Royan Institute were chosen for primary screening and detection of the presence of CT. 93 samples were normozoospermia with normal sperm parameters i.e. sperm number, motility and morphology (Asymptomatic) and 372 had abnormal sperm parameters (Symptomatic) in semen analysis. ELISA test was performed as the screening test. Samples with optical density (OD) >0.200 were selected as the case and asymptomatic samples with OD <0.200 were selected as the control group for the confirmatory test. PCR assay was used to confirm the serological results.
Results: In the case groups (n=62), 4 out of 32 symptomatic samples (12.5%), and 1 out of 30 asymptomatic samples (3.3%) revealed positive results in PCR. No PCR positive sample was observed in the control group (n=34). The final results revealed that considering OD >0.400 as the ELISA positive, the diagnostic value of CT-ELISA positive in symptomatic and asymptomatic infertile patients were 0.019 (7 of 372) and 0.021 (2 of 93), respectively. There was no relationship between the presence of CT infection and different sperm abnormalities.
Conclusion: The anti-CT IgA ELISA test may be introduced as an appropriate tool for screening purpose in the seminal plasma to select suspicious samples for PCR confirmatory tests.
Objective: The main objective of this study was to determine the diagnostic value of polymerase chain reaction (PCR) and enzyme linked immuno sorbent assay (ELISA) for screening and detecting CT in semen samples of infertile men.
Materials and Methods: In this cross-sectional study, 465 men referring to the clinical laboratory of Royan Institute were chosen for primary screening and detection of the presence of CT. 93 samples were normozoospermia with normal sperm parameters i.e. sperm number, motility and morphology (Asymptomatic) and 372 had abnormal sperm parameters (Symptomatic) in semen analysis. ELISA test was performed as the screening test. Samples with optical density (OD) >0.200 were selected as the case and asymptomatic samples with OD <0.200 were selected as the control group for the confirmatory test. PCR assay was used to confirm the serological results.
Results: In the case groups (n=62), 4 out of 32 symptomatic samples (12.5%), and 1 out of 30 asymptomatic samples (3.3%) revealed positive results in PCR. No PCR positive sample was observed in the control group (n=34). The final results revealed that considering OD >0.400 as the ELISA positive, the diagnostic value of CT-ELISA positive in symptomatic and asymptomatic infertile patients were 0.019 (7 of 372) and 0.021 (2 of 93), respectively. There was no relationship between the presence of CT infection and different sperm abnormalities.
Conclusion: The anti-CT IgA ELISA test may be introduced as an appropriate tool for screening purpose in the seminal plasma to select suspicious samples for PCR confirmatory tests.
Type of Study: Original Article |
References
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7. Stamm WE. Chlamydia trachomatis infections: progress and problems. J Infect Dis 1999; 179 (Suppl.): S380-383. [DOI:10.1086/513844]
8. Young H, Moyes A, Horn K, Scott GR, Patrizio C, Sutherland S. PCR testing of genital and urine specimens compared with culture for the diagnosis of chlamydial infection in men and women. Int J STD AIDS 1998; 9: 661-665. [DOI:10.1258/0956462981921314]
9. Bax CJ, Mutsaers JA, Jansen CL, Trimbos JB, Dörr PJ, Oostvogel PM. Comparison of serological assays for detection of Chlamydia trachomatis antibodies in different groups of obstetrical and gynecological patients. Clin Diagn Lab Immunol 2003; 10: 174-176. [DOI:10.1128/CDLI.10.1.174-176.2003]
10. World Health Organisation. WHO Laboratory Manual for the Examination and Processing of Human Semen. 5th Ed. Geneva, World Health Organisation; 2010.
11. Barlow RE, Cooke ID, Odukoya O, Heatley MK, Jenkins J, Narayansingh G, et al. The prevalence of Chlamydia trachomatis in fresh tissue specimens from patients with ectopic pregnancy or tubal factor infertility as determined by PCR and in-situ hybridisation. J Med Microbiol 2001; 50: 902-908. [DOI:10.1099/0022-1317-50-10-902]
12. Bjartling C, Osser S, Persson K. Deoxyribonucleic acid of Chlamydia trachomatis in fresh tissue from the Fallopian tubes of patients with ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol 2007; 134: 95-100. [DOI:10.1016/j.ejogrb.2006.06.010]
13. Hamdad-Daoudi F, Petit J, Eb F. Assessment of Chlamydia trachomatis infection in asymptomatic male partners of infertile couples. J Med Microbiol 2004; 53: 985-990. [DOI:10.1099/jmm.0.45641-0]
14. Hosseinzadeh S, Eley A, Pacey AA. Semen quality of men with asymptomatic chlamydial infection. J Androl 2004; 25: 104-109. [DOI:10.1002/j.1939-4640.2004.tb02764.x]
15. Saeedzadeh A, Hosseinzadeh S, Firouzi R. Genotyping of Chlamydia trachomatis from endocervical specimens in Shiraz, Iran. Iran J Vet Res 2013; 14: 203-210.
16. Claas HC, Melchers WJ, Bruijn DIH, Graaf DM, Dijk VWC, Lindeman J, et al. Detection of Chlamydia trachomatis in clinical specimens by the polymerase chain reaction. Eur J Clin Microbiol Infect Dis 1990; 9: 864-868. [DOI:10.1007/BF01967500]
17. Refaat B, Al-Azemi M, Geary I, Eley A, Ledger W. Role of activins and inducible nitric oxide in the pathogenesis of ectopic pregnancy in patients with or without Chlamydia trachomatis infection. Clin Vaccine Immunol 2009; 16: 1493-1503. [DOI:10.1128/CVI.00221-09]
18. Agresti A, Coull BA. Approximate is better than "exact" for interval estimation of binomial proportions. Am Stat 1998; 52: 119-126.
19. Bukharin OV, Kuz'min MD, Ivanov IuB. The role of the microbial factor in the pathogenesis of male infertility. Zh Mikrobiol Epidemiol Immunobiol 2003; 2: 106-110.
20. Washington AE, Johnson RE, Sanders LL Jr. Incidence of Chlamydia trachomatis infections in the United States: using reported Neisseria gonorrhoea as a surrogate. Proceedings of the 6th International Symposium on Human Chlamydial Infections; Cambridge University Press, Cambridge, England 1986.
21. Massari V, Dorleans Y, Flahault A. Persistent increase in the incidence of acute male urethritis diagnosed in general practices in France. Br J Gen Pract 2006; 56: 110-114.
22. Ghanaat J, Afshari JT, Ghazvini K, Malvandi M. Prevalence of genital Chlamydia in Iranian males with urethritis attending clinics in Mashhad. East Mediterr Health J 2008; 14: 1333-1337.
23. Asgari S, Chamani Tabriz L, Allami A, Asadi S, Zeraati H, Gachkar L, et al. Urogenital Chlamydia trachomatis infection among prisoner men. Iran J Clin Infect Dis 2011; 6, 74-77.
24. Sadrpour P, Bahador A, Asgari S, Bagheri R, Chamani-Tabriz L. Detection of Chlamydia trachomatis and Mycoplasma genitalium in semen samples of infertile men using multiplex PCR. Tehran Univ Med J 2013; 70: 623-629.
25. Günyeli I, Abike F, Dünder I, Aslan C, Tapisiz ÖL, Temizkan O, et al. Chlamydia, Mycoplasma and Ureaplasma infections in infertile couples and effects of these infections on fertility. Arch Gynecol Obstet 2011; 283: 379-385. [DOI:10.1007/s00404-010-1726-4]
26. Gdoura R, Kchaou W, Ammar-Keskes L, Chakroun N, Sellemi A, Znazen A, et al. Assessment of Chlamydia trachomatis, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, and Mycoplasma genitalium in semen and first void urine specimens of asymptomatic male partners of infertile couples. J Androl 2008; 29: 198-206. [DOI:10.2164/jandrol.107.003566]
27. Liu J, Wang Q, Ji X, Guo S, Dai Y, Zhang Z, et al. Prevalence of Ureaplasma urealyticum, Mycoplasma hominis, Chlamydia trachomatis infections, and semen quality in infertile and fertile men in China. Urology 2014; 83: 795-799. [DOI:10.1016/j.urology.2013.11.009]
28. Witkin SS, Kligman I, Bongiovanni AM. Relationship between an asymptomatic male genital tract exposure to Chlamydia trachomatis and an autoimmune response to spermatozoa. Hum Reprod 1995; 10: 2952-2955. [DOI:10.1093/oxfordjournals.humrep.a135827]
29. Cengiz T, Aydoganli L, Baykam M, Mungan NA, Tuncbilek E, Dincer M, et al. Chlamydial infections and male infertility. Int Urol Nephrol 1997; 29: 687-693. [DOI:10.1007/BF02552187]
30. Golshani M, Eslami G, Mohhammadzadeh Ghobadloo Sh, Fallah F, Goudarzi H, Soleimani Rahbar AA, et al. Detection of Chlamydia trachomatis, mycoplasma hominis and Ureaplasma urealyticum by multiplex PCR in Semen sample of infertile men. Iran J Publ Health 2007; 36: 50-57
31. Keck C, Gerber-Schafer C, Clad A, Wilhelm C, Breckwoldt M. Seminal tract infections: impact on male fertility and treatment options. Hum Reprod Update 1998; 4: 891-903. [DOI:10.1093/humupd/4.6.891]
32. Askienazy-Elbhar M. Male genital tract infection: the point of view of the bacteriologist. Gynecol Obstet Fertil 2005; 33: 691-697. [DOI:10.1016/j.gyobfe.2005.07.008]
33. Stephens RS, Kalman S, Lammel C, Fan J, Marathe R, Aravind L, et al. Genome sequence of an obligate intracellular pathogen of humans: Chlamydia trachomatis. Science 1998; 282: 754-759. [DOI:10.1126/science.282.5389.754]
34. Dean, D. Chlamydia trachomatis today: treatment, detection, immunogenetics and the need for a greater global understanding of chlamydial disease pathogenesis. Drugs Today (Barc) 2009; 45 (Suppl. B): 25-31.
35. World Health Organization (WHO). Chlamydia trachomatis, In: Initiative for Vaccine Research (IVR): Sexually Transmitted Diseases, 07.06.2011, Available at: http://www.who.int/vaccine_research/ diseases/soa_std/en/index1.html.
36. Skidmore S, Horner P, Mallinson H. Testing specimens for Chlamydia trachomatis. Sex Transm Infect 2006; 82: 272-275. [DOI:10.1136/sti.2005.019034]
37. Stamm WE. Chlamydia trachomatis infections: progress and problems. J Infect Dis 1999; 179 (Suppl.): S380-383. [DOI:10.1086/513844]
38. Young H, Moyes A, Horn K, Scott GR, Patrizio C, Sutherland S. PCR testing of genital and urine specimens compared with culture for the diagnosis of chlamydial infection in men and women. Int J STD AIDS 1998; 9: 661-665. [DOI:10.1258/0956462981921314]
39. Bax CJ, Mutsaers JA, Jansen CL, Trimbos JB, Dörr PJ, Oostvogel PM. Comparison of serological assays for detection of Chlamydia trachomatis antibodies in different groups of obstetrical and gynecological patients. Clin Diagn Lab Immunol 2003; 10: 174-176. [DOI:10.1128/CDLI.10.1.174-176.2003]
40. World Health Organisation. WHO Laboratory Manual for the Examination and Processing of Human Semen. 5th Ed. Geneva, World Health Organisation; 2010.
41. Barlow RE, Cooke ID, Odukoya O, Heatley MK, Jenkins J, Narayansingh G, et al. The prevalence of Chlamydia trachomatis in fresh tissue specimens from patients with ectopic pregnancy or tubal factor infertility as determined by PCR and in-situ hybridisation. J Med Microbiol 2001; 50: 902-908. [DOI:10.1099/0022-1317-50-10-902]
42. Bjartling C, Osser S, Persson K. Deoxyribonucleic acid of Chlamydia trachomatis in fresh tissue from the Fallopian tubes of patients with ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol 2007; 134: 95-100. [DOI:10.1016/j.ejogrb.2006.06.010]
43. Hamdad-Daoudi F, Petit J, Eb F. Assessment of Chlamydia trachomatis infection in asymptomatic male partners of infertile couples. J Med Microbiol 2004; 53: 985-990. [DOI:10.1099/jmm.0.45641-0]
44. Hosseinzadeh S, Eley A, Pacey AA. Semen quality of men with asymptomatic chlamydial infection. J Androl 2004; 25: 104-109. [DOI:10.1002/j.1939-4640.2004.tb02764.x]
45. Saeedzadeh A, Hosseinzadeh S, Firouzi R. Genotyping of Chlamydia trachomatis from endocervical specimens in Shiraz, Iran. Iran J Vet Res 2013; 14: 203-210.
46. Claas HC, Melchers WJ, Bruijn DIH, Graaf DM, Dijk VWC, Lindeman J, et al. Detection of Chlamydia trachomatis in clinical specimens by the polymerase chain reaction. Eur J Clin Microbiol Infect Dis 1990; 9: 864-868. [DOI:10.1007/BF01967500]
47. Refaat B, Al-Azemi M, Geary I, Eley A, Ledger W. Role of activins and inducible nitric oxide in the pathogenesis of ectopic pregnancy in patients with or without Chlamydia trachomatis infection. Clin Vaccine Immunol 2009; 16: 1493-1503. [DOI:10.1128/CVI.00221-09]
48. Agresti A, Coull BA. Approximate is better than "exact" for interval estimation of binomial proportions. Am Stat 1998; 52: 119-126.
49. Bukharin OV, Kuz'min MD, Ivanov IuB. The role of the microbial factor in the pathogenesis of male infertility. Zh Mikrobiol Epidemiol Immunobiol 2003; 2: 106-110.
50. Washington AE, Johnson RE, Sanders LL Jr. Incidence of Chlamydia trachomatis infections in the United States: using reported Neisseria gonorrhoea as a surrogate. Proceedings of the 6th International Symposium on Human Chlamydial Infections; Cambridge University Press, Cambridge, England 1986.
51. Massari V, Dorleans Y, Flahault A. Persistent increase in the incidence of acute male urethritis diagnosed in general practices in France. Br J Gen Pract 2006; 56: 110-114.
52. Ghanaat J, Afshari JT, Ghazvini K, Malvandi M. Prevalence of genital Chlamydia in Iranian males with urethritis attending clinics in Mashhad. East Mediterr Health J 2008; 14: 1333-1337.
53. Asgari S, Chamani Tabriz L, Allami A, Asadi S, Zeraati H, Gachkar L, et al. Urogenital Chlamydia trachomatis infection among prisoner men. Iran J Clin Infect Dis 2011; 6, 74-77.
54. Sadrpour P, Bahador A, Asgari S, Bagheri R, Chamani-Tabriz L. Detection of Chlamydia trachomatis and Mycoplasma genitalium in semen samples of infertile men using multiplex PCR. Tehran Univ Med J 2013; 70: 623-629.
55. Günyeli I, Abike F, Dünder I, Aslan C, Tapisiz ÖL, Temizkan O, et al. Chlamydia, Mycoplasma and Ureaplasma infections in infertile couples and effects of these infections on fertility. Arch Gynecol Obstet 2011; 283: 379-385. [DOI:10.1007/s00404-010-1726-4]
56. Gdoura R, Kchaou W, Ammar-Keskes L, Chakroun N, Sellemi A, Znazen A, et al. Assessment of Chlamydia trachomatis, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, and Mycoplasma genitalium in semen and first void urine specimens of asymptomatic male partners of infertile couples. J Androl 2008; 29: 198-206. [DOI:10.2164/jandrol.107.003566]
57. Liu J, Wang Q, Ji X, Guo S, Dai Y, Zhang Z, et al. Prevalence of Ureaplasma urealyticum, Mycoplasma hominis, Chlamydia trachomatis infections, and semen quality in infertile and fertile men in China. Urology 2014; 83: 795-799. [DOI:10.1016/j.urology.2013.11.009]
58. Witkin SS, Kligman I, Bongiovanni AM. Relationship between an asymptomatic male genital tract exposure to Chlamydia trachomatis and an autoimmune response to spermatozoa. Hum Reprod 1995; 10: 2952-2955. [DOI:10.1093/oxfordjournals.humrep.a135827]
59. Cengiz T, Aydoganli L, Baykam M, Mungan NA, Tuncbilek E, Dincer M, et al. Chlamydial infections and male infertility. Int Urol Nephrol 1997; 29: 687-693. [DOI:10.1007/BF02552187]
60. Golshani M, Eslami G, Mohhammadzadeh Ghobadloo Sh, Fallah F, Goudarzi H, Soleimani Rahbar AA, et al. Detection of Chlamydia trachomatis, mycoplasma hominis and Ureaplasma urealyticum by multiplex PCR in Semen sample of infertile men. Iran J Publ Health 2007; 36: 50-57
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