Chlamydial infection in asymptomatic infertile men attending an andrology clinic

Urethral swabs, first-catch urine or urine collected at least 2 h after the previous micturition, and semen swabs were collected from 131 asymptomatic men during the routine workup for infertility at the andrology clinic at Ga-Rankuwa Hospital, Medunsa. The urethral and seminal swabs were used for enzyme immunoassay (EIA) (IDEIA III), tissue culture, and direct immunofluorescent antibody (DFA) test (IMAGEN) to detect Chlamydia trachomatis, and similarly the urine was tested by EIA. In 82/131 (62.6%) cases all tests for chlamydiae were negative and in 49/131 (37.4%) cases at least one test was positive. Tissue culture detected 24/131 (18.3%) as positive for C. trachomatis. Urethral swab EIA detected 33/131 (25.2%) and DFA 34/131 (26%) positive patients. Urine EIA was positive in 33/131 cases (25.2%). Semen EIA was positive in 35/131 (26.7%) of cases of whom 7/131 (5.3%) were positive in semen EIA only (all samples were conformed by PCR). It would seem, therefore, that testing for the presence of chlamydia was incomplete if semen samples were not included. The positivity in only semen samples raises the possibility that the organisms are harbored in the epididymis, seminal vesicles, or the prostate.