Microsoft word - mensfe chlamdia men.doc

Sourse of data: Health protection Agency, Times database (UK)
Male infertility alert over hidden bacteria.
Chlamydia, the sexually transmitted infection (STI) carried by one in ten
sexually-active young British adults can make men infertile by damaging
the quality of their sperm, new research has shown. While the condition
which is usually passed on undetected, has long been known to threaten
female fertility, scientists in Spain and Mexico has now established that it
is presents similar risks for men.
Men with chlamydia have three times the normal number of sperm with
genetic damage that can impair the ability to father children, the study
found. Antibiotic treatment can reverse the effect and preliminary results
indicate that it may dramatically enhance pregnancy rates when couples
are trying for a baby. But the discovery suggests that the prevalence of
the disease may contribute to infertility across an entire generation of
young adults.
Britain’s national screening programme has found that 10-2 per cent of
both men and women aged 18 to 25 carry the bacteria, and studies have
found infection rates as high as 5 per cent among older groups with a
lower risk.
The findings indicate that untreated chlamydia infections should not just
concern women, who have long been warned that the condition can make
them infertile but has direct consequences for men.
This will create fresh pressures for chlamydia screening to be more
effectively targeted at young men who rarely seek testing and treatment
unless they develop symptoms which are often absent or quickly fade.
Doctors have already warned that the rise in the number of chlamydia
cases in Britain may rob thousands of young women of the chance to
have children. Figures from the Health Protection Agency reveal that
cases of chlamydia have increased by more than 200 per cent in England
in the past decade.
Chlamydia is easily treated with antibiotics, typically a week’s course of
Doxycyclone or a single dose of Azithromycin, but testing is necessary
first. Allan Pacey senior lecturer in andrology at the university of
Sheffield, said that the emerging understanding of how chlamydia affects
male fertility should change the way that society approaches the condition. “We might think of chlamydia as a disease that damages female fertility, but we need to think again,” he said, “It does damage female fertility but it appears ti damage male fertility, too. Previously it was thought that the most worrying thing about chlamydia infections in men was a conduit for the infection of women. The thing that drives most men to sexual health clinics is symptoms, and chlamydia is symptom free. Chlamydia is getting out of control. We have got to encourage men as well as women to go for screening.” In the study, a team led by Jose luis Fernandez of the Juan Cana-lejo University Hospital in La Couna examined sperm samples taken from 193 men seeking fertility treatment with their partners. Of these, 143 were infected with both chlamydia and mycoplasma, another common sexually transmitted bacterium, while 50 were unifected and served as healthy controls. Dr Fernandez, who will present his findings today at the American Society for reproduction Medicine conference in Washington, then examined the men’s sperm for a form of genetic damage called DNA fragmentation. This can cause sperm to die, as well as hindering their ability to fertilise eggs and embryonic development. An average of 35 per cent of the infected men’s sperm was damaged, a proportion 3-2 times higher than in the healthy control’s. “We found there was a three fold increase in the fragmentation of DNA in sperm cells compared with controls, and this could have a potential role in subfertility, Dr Fernadez said. In the infected group, both partners were treated with antibiotics. During the early stages of treatment, just 12-5 per cent of the couples conceived but when therapy was complete, 85-7 per cent had achieved a pregnancy. Successful treatment of the male partner is more likely to have been responsible for this effect. Chlamydia causes female infertility as a result of chronic infection, which causes damage to the fallopian tubes and once this has occurred it is not usually reversed by treatment. Men however produce new sperm so quickly and in such abundance that removing the infection will rapidly improve sperm quality. After treatment the infected men produce many fewer genetically damaged sperm.
“After four months of treatment there was a significant decrease in DNA
that could improve pregnancy rates in these couples, “ Dr Fernandez said.
“It seems related to an improved pregnancy rate. It’s a very dramatic
difference, but this is a small number of couples, so the results are only
preliminary.”
The findings suggest that infertility patients of both sexes should be
routinely screened for chlamydia, as already happens in most British
clinics. Dr Pacey said;” “I would advice couples who are trying for a
baby to be screened for chlamidia. The difficulty is that a positive
diagnosis carries implications of infidelity, but of course as it can be
symptomatic the infection can have been there for years.”
Chalmydia’s on female infertility are well established. If untreated up to
40 per cent of women will develop pelvic inflammatory disease, which
can cause tubal scarring that leads to infertility and an increased risk of
ectopic pregnancy.
In men, chlamydia can lead to swelling of the testicles or epidymis, and
either can case sterility if not treated. However both conditions are
generally treated before they cause long term damage as they are painful.
Most commonly transmitted infection:
Chlamydia is caused by the bacterium Chlamydia trachomatis.
It is the most commonly sexually transmitted infection in Britain,
with 109,958 confirmed diagnosed in 2005, and the incidence is
increasing.
The true figure is thought to be much higher as the condition often
has no symptoms and can pass undetected for years.
Symptoms can include discharge from the vagina or penis or pain on
urination, but often has no symptoms at all.
A study of male Army recruits found that one in ten had chlamydia,
but 88 per cent of these had no symptoms.
Left untreated it will cause pelvic inflammatory disease in 40 per cent
of women. This can cause scarring to the fallopian tubes, leading ti
infertility or a raised ectopic pregnancy.
In men it can cause Epididymitis or Orchitis – swelling of the
epidymis at the top of the testicle, or of the testicle itself. This is
painful and can cause scarring and infertility if untreated.
Chlamydia can be detected by a simple urine test:
Swabs are no longer necessary.
Postal kits are available from Boots at aprox. £25-00 and a national
free screening programme exists for the under 25’s.
Pip Reilly.

Source: http://www.mensfe.net/images/chlamydia.pdf