The triple method of semen bacterial culture is used to check male infertility and when there is evidence of urogenital infection. It includes testing for pathogenic aerobic and anaerobic microorganisms, fungi, and gonococcus. The triple method involves microbiological testing of two urine samples before and after ejaculation, in addition to microbial testing of semen.
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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 that 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 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 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 gland dysfunction. The latter is responsible for the insufficient secretion of enzymes, minerals, and fluids required for optimal spermatozoa function and transport. The 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 and 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.
The triple method of semen bacterial culture is a modification of the Meares—Stamey method that can help accurately detect and document infections of the male urogenital system.
