Chlamydia trachomatis and male infertility:: chlamydia-IgA antibodies in seminal plasma are C-trachomatis specific and associated with an inflammatory response

Background There is controversy over the role of asymptomatic genital tract infection by Chlamydia trachomatis, its optimal diagnosis, and its place in the etiology of male infertility. Objective Comparision of direct detection of Chlamydia trachomatis in semen with the presence of chlamydia-antibodies in seminal plasma and serum, together with parameters of the spermatogram, in men of infertile relationships. Study design Prospective clinical study, Setting University hospital tertiary referral center. Subjects and methods Two groups of consecutive andrological patients (n = 89 and n = 36) were investigated as follows: semen analysis, including concentration of granulocyte-elastase; detection of C. trachomatis in semen samples and first void urine by polymerase chain reaction (PCR) and antigen-ELISA (Celisa(R)); detection of chlamydia antibodies in serum and seminal plasma by recombinant antibody-enzyme-linked immunosorbent assay (rELISA(R)) and of Chlamydia trachomatis specific antibodies by the ImmunoComb(R)-Chlamydia-Bivalent test. Results In 2/125 (1.6%) semen samples Chlamydia trachomatis DNA was detected by PCR. Genus specific anti-chlamydia-IgA was found in 12/122 (9%) of the seminal plasmas. This IgA appeared to be specific for C. trachomatis. Seminal plasmas with chlamydia-IgA antibodies showed higher PMN-elastase levels than IgA negative samples (P < 0.04). Chlamydia-IgG antibodies were present in 27/89 (30%) of the sera, but in only five of these 27 sera (19%) were the antibodies detected specific for C. trachomatis, There were no associations between any of these variables and the parameters of the routine semen analysis. Conclusion IgA-chlamydial antibodies in seminal plasma appeared to be specific against C. trachamatis and were associated with an inflammatory response in the male genital tract. (C) 1999 Elsevier Science B.V. All rights reserved.