Infertility is defined as the inability to become pregnant after 12 months of having unprotected sex. It affects men and women around the world. Prevalence varies from region to region, but an average of 40 to 50 million people are likely to suffer from this condition. In recent years the medium-term and short-term consequences of Sexually Transmitted Infections (STIs) caused by Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum have been recognized as causing infertility in men and women.
Neisseria gonorrhoeae - Gonorrhea: Gonorrhea is currently maintained as one of the most important sexually transmitted diseases. This disease is caused by the bacterium Neisseria gonorrhoeae, showing infection in men as acute urethritis and in women such as cervicitis. The percentage of asymptomatic infections in men is around 5% of cases, being higher in women. The detection and treatment of people with gonorrhea is important not only to eliminate their ability to transmit the bacteria to their sexual partners but also because of the serious medical complications that can result from continued infection. In the case of men, it can cause epididymitis and prostatitis, whereas in women it can lead to Pelvic Inflammatory Disease, sterility and ectopic pregnancy.
Chlamydia trachomatis: Chlamydia trachomatis is the most common bacterial pathogen in sexually transmitted diseases. Infection with C. trachomatis in women, without adequate treatment, can result in up to 40% of cases in Pelvic Inflammatory Disease, which can lead to infertility, chronic pelvic pain and ectopic pregnancy. Other consequences of infection without treatment with chlamydia are, the increased risk of HIV infection as well as transmission to the neonate, which is the most common cause of conjunctivitis and pneumonia in the newborn. Since up to 75% of the cases, C. trachomatis infection may be asymptomatic, and it is for this reason that several medical organizations recommend carrying out routine tests to search for this bacterium in sexually active and pregnant women. C. trachomatis infection in men causes urethritis and epididymitis (infection of the spermatic ducts) although up to 50% of the infections do not produce symptoms of the disease. Mycoplasma hominis and Ureaplasma urealyticum: Both species, belonging to the same family, are known as genital organisms, are considered opportunistic that cause invasive infections in susceptible populations. Because of its fastidious nature and the lack of reliable culture media, the detection of these organisms is performed by molecular techniques. Urealyticum and M. hominis are causes of urethritis, pyelonephritis, prostatitis, epididymitis and impaired sperm function in men. In women, infertility can cause pelvic inflammatory disease, and during pregnancy can cause inflammation of the placenta and can invade the amniotic sac easily, causing persistent infection and problems in pregnancy, including abortions, premature rupture of membranes and premature births. Colonization in children by both organisms can occur by ascent of microorganisms from the lower genital tract of the mother at the time of delivery or by direct invasion of the fetus in the uterus. Ureaplasma Urealyticum is a small size coccidian bacteria without a wall. It causes infections such as non-gonococcal urethritis, prostatitis and cystitis; in patients with hypogammaglobulinemia can become chronic. In women it can cause cervicitis, endometritis, however, 60% of asymptomatic women possess U. urealyticum in the genital tract. Together with M. hominis, they have also been associated with premature births, threatened abortions, miscarriages, chorioamnioitis. Several studies have documented perinatal vertical transmission of U. Urealyticum in preterm neonates and have been identified in infants born dead and preterm and low birth weight infants with instertitial pneumonia, although the pathogenic mechanism is unclear, this bacterium somehow has the ability to participate in chronic lung disease of newborns.