Semen, Bacterial Culture, Triple Method is used to check male infertility as well as when there is evidence of urogenital infection and includes the test for pathogenic aerobic and anaerobic microorganisms, fungi, and gonococcus. The triple method involves, in addition to microbiological testing of semen, microbiological testing of two urine samples, before and after ejaculation.
Urogenital tract infections are relatively common in the male population. Infections include (a) cystourethritis (infection of the bladder and urethra) caused by common bacteria that infect the urinary tract or sexually transmitted pathogens and (b) infections involving the prostate, urethra, and semen and may affect fertility.
The possible link between infection and infertility has long been the subject of research. Understanding the relationship between accessory gland infections and reduced male fertility has acquired scientific and diagnostic tools, but the results of antibiotic treatment in terms of fertility remain disappointing. The latter is probably due to irreversible functional damage caused by chronic infections and inflammation. Therefore, the prevention, early diagnosis, and adequate treatment of infections of the male urogenital system, both by common microbes and by sexually transmitted microorganisms, are vital.
Infection of the accessory glands includes epididymitis, spermatocystitis, and prostatitis and is caused by either sexually transmitted microbes or the so-called common uropathogens. Among the sexually transmitted microorganisms, Chlamydia trachomatis is the most common pathogen, but Gonococcus (Neisseria gonorrhoeae) is also quite common. Common uropathogens are usually Escherichia coli, group D Streptococcus (Enterococcus), Proteus, and Klebsiella species. The role of coagulase-negative Staphylococci in these infections remains uncertain.
The infection causes inflammation characterized by common symptoms such as pain, swelling, and dysfunction of the gland. The latter is responsible for the insufficient secretion of enzymes, minerals, and fluids required for optimal function and transport of spermatozoa. Abnormal biochemical composition of semen plasma results in reduced sperm volume, abnormal viscosity and liquefaction, abnormal pH, and reduced sperm functional capacity. This can typically be expressed as reduced mobility and in many cases with anti-sperm antibodies that cause immune infertility.
The infection increases the number of white blood cells, the production of reactive oxygen species (ROS) that alter the lipid composition of the sperm membrane and reduce the acrosome activity. Reactive oxygen species induce oxidative damage to sperm DNA by producing 8-hydroxy-deoxyguanosine (8-OHdG) and generating mutations. Inflammation also increases the production of cytokines such as Interleukin-1 (IL-1α and IL-1β), Interleukin-6 (IL-6), Interleukin-8 (IL-8), and Tumor Necrosis Factor-alpha (TNF-a) which further limit sperm function.
Semen, Bacterial Culture, Triple Method is a modification of the Meares - Stamey method and can help in the accurate detection and documentation of the infection of the male urogenital system.