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A total of 196 patients attending the Center of Dermatology and Andrology, Giessen, Germany, were examined for fertility problems. Polymorphonuclear elastase, reactive oxygen species (ROS and the number of round and peroxidase-positive cells were investigated in addition to routine semen analysis. The ejaculates were also analysed before and after sperm separation by means of swim-up or glass wool filtration. In 20 cases of leukocvtospermia, sperm concentration, motility, viability, production of reactive oxygen species. and the number of peroxidase- positive cells were evaluated before and after glass wool filtration. The results show that ROS production by viable spermatozoa is highly correlated with the concentration of PMN elastase and the number of both peroxidase-positive and round cells. Multiple regression analysis with motility as dependent parameter showed the number of round cells (n=91; r= -0.332; P=0.0030) to be the most important parameter affecting motility, while ROS mainly affects the viability of spermatozoa (n=69; r=0.250; P=0.0107). In the ease of leukocytospermia, glass wool filtration significantly reduced the number of peroxidase-positive cells and ROS production (P=0.0098 and P=0.0005, respectively). Receiver operating characteristic (ROC) curve analysis for ROS production in the ejaculate using a concentration of 1.000 ng ml -1 PMN elastase as decisive parameter resulted in a rut-off value of 49,489.9 counts 10-7 viable spermatozoa. The statistical parameters were: Sensitivity: 63.2%, specificity: 100%, positive predictive value: 100%, negative predictive value: 36.1%. [ABSTRACT FROM AUTHOR]

Urogenital infections with Chlamydia trachomatis belong to the most prevalent sexually-transmitted bacterial diseases. In women, they can cause chronic salpingitis with subsequent tubal infertility and ectopic pregnancies. In men, C. trachomatis can cause urethritis, prostatitis and epididymitis. Urogenital infections can be symptomatic or asymptomatic. Symptomatic urogenital infections might impair male fertility. In vitro, C. trachomatis affects sperm motility and viability. However, there is no clear evidence that asymptomatic urogenital infections have an adverse effect on male fertility. Because C. trachomatis can be sexually transmitted and lead to female infertility, it is also of significance in male infertility work-up. Because of their high sensitivity, nucleic acid amplification tests should be used to examine first-void urine specimens. Both partners should be treated. The role of Ureaplasma urealyticum in reproductive medicine has been discussed controversially. There is no evidence that U. urealyticum has a significant impact on female or male infertility. [ABSTRACT FROM AUTHOR]