Men may have infections of their reproductive tract. These may
include infections of the prostate (prostatitis), of the epididymis
(epididymitis), or of the testes (orchitis).
Post-pubertal viral infections of the testes may cause significant
damage (atrophy) of the testes and may cause absolute and
irreversible infertility. Bacterial infections or sexually
transmitted diseases may cause blockages at the sperm ducts. The
patient may have normal production of sperm, but the ducts carrying
it are obstructed.
Active bacterial or viral infections may have a negative effect on
sperm production or sperm function. White blood cells, which are the
body's response to infection, may also have a negative effect on
sperm membranes, making them less hearty.
If excessive white blood cells or bacteria (more than one
million/cc) are seen in a semen specimen, cultures should be done.
This usually includes cultures for commonly asymptomatic,
sexually-transmitted diseases including mycoplasma, ureaplasma, and
Chlamydia. Also, a general genital culture is usually taken. If the
infection and the white blood cells are persistent, antibiotics may
be considered.
It is important to note that, in most men, the ejaculate is not
sterile. In controlled studies, the average man will culture
positive for approximately two organisms. It is therefore very
important to be judicious in the treatment of
non-sexually-transmitted organisms found on cultures. |
