H. pylori infection plays a detrimental role in semen quality of men with idiopathic infertility

Introduction and Aim. Helicobacter pylori infection is associated with extra‐digestive disorders, also concerning male infertility. Our aim was to explore the possibility that the overall H. pylori and CagA‐positive H. pylori infection play a detrimental role on sperm quality. Methods. Semen samples from 80 men with idiopathic infertility were evaluated following 1999 WHO guidelines. Ultrastructural sperm analysis mathematically elaborated allowed to obtain a fertility index and the percentage of sperm immaturity, necrosis, and apoptosis. Enzyme‐linked immunosorbent assay was used to determine the H. pylori infection and the CagA status (confirmed by Western blotting) and to detect systemic levels of IL‐6 and TNF‐α. Results. Thirty‐six patients (45%) were H. pylori positive (HP+) and 44 patients were seronegative (55%); 17 of 36 patients (47.2%) were CagA positive (CagA+) and 19 patients (52.7%) were CagA negative (CagA–). HP+ patients showed decreased motility (not statistically significant) and fertility index (p < .05), with an increased necrosis (NS), respect to uninfected patients. Compared with HP+/CagA– patients, the HP+/CagA+ group highlighted a significant reduction (p < .05) in sperm motility (medians 29% vs 18%) and in fertility index (32,041 vs 16,056) concomitant with significantly higher (p < .05) percentages of sperm apoptosis (7.7% vs 11.1%) and necrosis (51.0% vs 59.1%). The mean level of TNF‐α in CagA+ infected patients was significantly higher than that measured in the uninfected group (12.1 ± 9.2 vs 8.5 ± 4.1). Conclusions. The negative influence of CagA+ infection on sperm quality may help understand the role of chronic infections in reproductive disorders.