Clinically "silent" chronic infections of the male accessory sexual glands have been reported to account for sub-fertility or infertility in men. 

Ejaculates containing pathogenic organisms have a lower fertilization rate, and antibiotic treatment of patients result in improved sperm motility and fertility.  However, empirical treatment with antibiotics may not always restore fertility since the suspected infection may not be of bacterial origin or the bacteria may be resistant to the antibiotic chosen. 

Pathogenic microorganisms such as Escherichia coli, bind directly onto the spermatozoa and can be transferred to the female partner during intrauterine insemination (IUI) and in-vitro fertilization (IVF). This may cause infection in artificially inseminated women and may affect the outcome of pregnancy and embryo development. In fact, an IVF center has reported cases of bacterial contamination of embryo cultures due to an infection in the male partner (Matilsky et al., The Clinical Embryologist 2005).

Microorganisms can be transmitted via IUI and IVF and therefore cannot be overlooked.  In order to remedy this transmission, it is necessary to perform a semen culture prior to insemination. However, routine semen cultures often do not yield meaningful results due to skin contaminants. This is further compounded by the lack of continued support and research in this area, a laboratory specializing in semen cultures is not readily available, and lacking such a facility makes it difficult for most physicians to diagnose such infections.  The critical clinical issue is, therefore, to distinguish patients with bacteriospermia from those patients who lack it.  It is therefore important to have a laboratory devoted mainly to performing semen culture for aerobic and anaerobic organisms.

OUR SEMEN CULTURE EXPERIENCE

Damirayakhian M, Land SA, Jeyendran RS: Significance of Semen Cultures for Men With Questionable Semen Quality, Archives in Andrology (in Press 2006):

One hundred and twenty nine asymptomatic patients were tested who exhibited questionable semen quality, poor motility, and/or increased leukocytes (WBC) in at least two consecutive ejaculates.  By culturing mid urine and semen collected following urination, we found:

• Positive semen cultures in 79.1% of these patients.

• Aerobic bacteria in 30.4% of the cultures.

• Anaerobic bacteria in 27.5% of the cultures.

• Aerobic and anaerobic bacteria in the remaining 42.2% of the cultures.

Thus eliminating the contaminating bacteria from the urinary tract, the clinically "silent" infection of the male genital tract was confirmed.  The high incidence of positive culture results suggests the importance of routine cultures.  The most efficient method to diagnose such a condition is by identifying the bacteria present in the urinary tract and the semen.

Other related publications:

Damirayakhian MA, Perez-Pelaez M, Jeyendran RS: Antibiotic susceptibility of prostatovesicular fluid isolates. Infertility 10:95-101, 1987

Perez-Pelaez M, Damirayakhian M, Jeyendran RS:  Endocervical culture isolates . Illinois Medical Journal 173 (2):112-114, 1988