Mark Henderson, Science Editor, in Washington
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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 usually passes undetected, has long been known to threaten female fertility, scientists from Spain and Mexico have now established that it presents similar risks for men.
Men with chlamydia have three times the normal number of sperm with genetic damage that can impair their 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 be contributing 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 pressure 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 doxycycline or a single dose of azithromycin, but testing is necessary first.
Allan Pacey, senior lecturer in andrology at the University of Sheffield and secretary of the British Fertility Society, 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 to damage male fertility, too.
“Previously, it was thought that the most worrying thing about chlamydia infections in men was as a conduit for the infection of women. The thing that drives most men to sexual health clinics is symptoms, and chlamydia is often 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 José Luis Fernández, of the Juan Cana-lejo University Hospital in La Coruña, examined sperm samples taken from 193 men seeking fertility treatment with their partners in Monterey, Mexico.
Of these, 143 were infected with both chlamydia and mycoplasma, another common sexually transmitted bacterium, while 50 were uninfected and served as healthy controls.
Dr Fernández, who will present his findings today at the American Society for Reproductive 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 controls.
“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 Fernández 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 partners 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 produced many fewer genetically damaged sperm.
“After four months of treatment, there was a significant decrease in DNA damage that could improve pregnancy rates in these couples,” Dr Fernández 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 advise couples trying for a baby to be screened for chlamydia. The difficulty is that a positive diagnosis carries implications of infidelity, but of course as it can be asymptomatic the infection could have been there for many years.”
Chlamydia’s effects on female infertility are well-established. If left 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 epididymis, and either can cause sterility if not treated. However, both conditions are generally treated before they cause long-term damage as they are painful.
Most common sexually transmitted infection
— Chlamydia is caused by the bacterium Chlamydia trachomatis
— It is the most common sexually transmitted infection in Britain, with 109,958 confirmed diagnoses 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 it 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 had no symptoms
— Left untreated, it will cause pelvic inflammatory disease in up to 40 per cent of women. This can cause scarring to the Fallopian tubes, leading to infertility or a raised risk of ectopic pregnancy
— In men, it can cause epididymitis or orchitis - swelling of the epididymis 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 £25, and a national free screening programme exists for under-25s
Source: Health Protection Agency, Times database
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Comment slightly off point but feel that I have to point out that there are some religious people who are not nut-jobs. These US nut jobs are the equivalent of islamic fundamentalists - they give non-judgemental Christians a bad name just as islamic fundamentalists give peaceful muslims a bad name. Jesus taught us to help the sick, not to judge etc. The way these nut-jobs condemn non-believers and even wish infertility on them is just SO non-christian. Shame on you.
Natasha, London,
Well written Adam,
Please can all these US fundamentalists keep their views to themselves and accept that, as in the true spirit of most religions, Britian is a tolerant and rational country which values free will.
I thought the basis of Christianity was supposed to be forgiveness anyway?!
Victoria, London, UK
It is amusingly ironic that someone writing in from the Playboy Mansion (Bill Maher) should be lecturing others about monogamy of all things! The word hypocrisy springs to mind.
Times Reader, London,
I agree with Nathan's statement. Where ever the Bible is taught and honored as truth people become progressively civil. Where ever the Bible is absent man progresses from self-indulgence (free sex, drug, violence, manipulation) to animalistic behavior and finally to self-destruction. America is the greatest example in history of a nation founded by God-fearing men on Biblical principles. The result is the wealthiest nation on earth with the most stable government (same constitution since 1776) in the history of the world.
John, Elon, NC USA
go ahead and lash out against the Religious. Looks like that's gotten the immoral folks pretty far hasn't it?
I'll stay religious!
I have coined this phrase and it is trademarked: "Religion without science is blind, but science without religion is deaf." Trademarked
It is very evident that those who don't want to hear anything about religion are deaf. They are like the child who won't listen and gets burned.
Sam, lebanon, IN
Whatever your morals are or whoever your maker was ( or wasn't) if ten percent of people have it and it can be easily cured, then finding out is so important and can prevent a lot of suffering. I commend the researchers for their efforts and recommend if you've got a spare 25 quid lying around you get the test.
Oh and as a "Brit" reading a British newspaper may I point out how displeasing it is to read comments wishing upon us mass infertility! Far too biblical for my tastes! I respectfully suggest such strange rude and ungodly wishes are best left unspoken in the minds of god-botherers, preferably in another publication so I shouldnt have to stumble across such pious nonsense.
Adam, London, England
"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."
Gosh - I didn't know it only robbed WOMEN of this chance!
How predictable that an article on male infertility won't even acknowledge that men, too, may be "robbed of the chance" to have children. A man's reaction to the possibility of never having children is not even touched on in this entire article. As a man I can tell you facing that prospect of being forever childless is horrible. But you just have to get used to the fact that all sympathy and concern will always be directed exclusively towards your partner. Your own feelings are irrelevant.
Is it because our society believes men don't mind if they never get to have kids? Or does our society simply not care? Clearly this writer doesn't feel it even merits a mention. So I'm guessing it's the latter.
David Space, London, UK
We need an AA day.
Antibiotics for all sexually active people and 5 days abstinence.
Chlamydia will be history (until someone goes abroad on holiday)
p s simon, London,
It seems silly to me that they are just now "discovering" that this STD also affects men. So NOW they are going to start screening for it. I mean, honestly, how did they think women were getting it? So, what, now they're going to start screening men because it affects their fertility ALSO? Come on, they should have been getting screened in the first place.
And I don't know what is up with religious people always saying that society is getting worse and blah, blah, blah. I am glad that I am living today as opposed to the crap people had to live through in the past. We are so much better now. Religious people like to try and paint this rosey picture about how "clean" and "right" people back in the day were, but they are obviously incorrect. Just read some history books to know that fact. People back in history were having all sorts of nasty sex with whoever. People were ignorant for a LONG time, too, about how reproduction worked.
We are so much BETTER OFF now!! And getting better.
Taylor, Colorado springs, CO
"being a religious nut-job I must say that if you practice abstinance [sic], you won't have to worry about std's."
Not true! Abstinence ONLY renders you immune to STDs if a) you are celibate your entire life (thus having removed oneself from the gene pool; OR b) BOTH you & your partner are celibate before marriage, AND remain 100% faithful.
(Omitting for the moment the unpleasant possibility of sexual assault, or "getting it from a toilet seat", etc.)
What proportion of Homo Sapiens, religious or not, meet these criteria? I'd guess 10% at the most -- and that's a very generous estimate!
Clearly, we should discourage promiscuity, encourage safer sex practices, and actively people screen for STDs, just as we screen for other diseases. This is a PUBLIC HEALTH issue, and we all have a stake in it!
"It's all in the value systems." I couldn't agree more. My values tell me that "Science without religion is lame; religion without science is blind." (Einstein)
Peace.
Brian, Everett,, WA (USA)
"Also it's quite entertaining to see the religious nut-jobs out in force in the comments - why are they always from the states?"
The reason they are from the states here is because the conservative Drudge Report linked to this article.
Carol, Florida, US
What's with this anti british, anti American stuff?
Sam Wagner, Quakertown, PA
being a religious nut-job I must say that if you practice abstinance, you won't have to worry about std's. It's all in the value systems. I must also pass on a note of regret that england doesn't have more religious nut-jobs. I also find it amusing that people who are so liberated in their thinking can only find negative things to say about those who profess a belief in God and Jesus Christ. I guess we are just too overbearing because we want people to lead whole productive lives that are free from many of the health and heart achs that debauchary leads to.
jason , owensboro, KY, USA
@Charles Miller:
It could also be that we are simply witnessing evolution in action. Those individuals are selected for, who can overcome adverse conditions in their environment, and still thrive and reproduce. Those who cannot be removed from the gene pool. In this case, those who have immune systems that are able to withstand infection with chlamydia and still produce healthy children will be selected for, and those who are rendered infertile by chlamydia will produce fewer offspring. Eventually the population will predominantly be filled with those who carry genes that give them resistance to chlamydia. Evolution in action!
[By the way, as an American, I would like to apologize for all of the religous nut-jobs who appear in response to stories like these. We are not all like this.]
Dale, San Francisco, CA, USA
It's about time a bit of infertility went round.
Also it's quite entertaining to see the religious nut-jobs out in force in the comments - why are they always from the states?
JonB, Glasgow, UK
The fact that chlamydia is largely asymptomatic but easily treatable indicates that a much more comprehensive screening programme is called for, beginning in schools.
It should be possible to wipe out this STD almost completely in the UK, along with a number of others.
Look what we did to syphilis and gonorrhoea.
Dave, Southampton, UK
Charles Miller, you're wrong. Dead wrong. And I must say that you are the ignorant one, like many others... willfully.
You can come up with whatever nonsense you like about why marriage is a part of life, but that won't change the facts. No, we did NOT evolve. Rather, we are becoming more and more degraded since the fall of man. Diseases like this happen for an obvious reason, and it isn't just physical degeneracy either...
Mankind, it seems, are becoming more like animals. Not using their higher centres of the brain properly. I am at times ashamed to be associated with this pathetic little world. Absolutely sickening.
Nathan, Bridgewater, Tasmania, Australia.
Well, the sooner the Brits go sterile the sooner the rest of us will have peace...
Playin Possum, Olympia , WA USA
This is another instance of Science playing catch-up to "ignorant" tradition. We humans evolved like most other species, with the strongest and SMARTEST humans living longer and more productively. It must have become obvious to our prehistoric ancestors that humans who exercised little self-discipline in sexual activity ended up diseased, weakened, and unable to reproduce in great numbers. Hence, our human societies concocted the numerous traditions of chastity, abstinence, fidelity, marriage and so forth...to PREVENT the spread of STDs and to strengthen the human herd. No doubt many of our religious customs were also born of the same prehistoric observance of sexual hygiene. So, here we are thousands of years later, casting off the rusted shackles of tradition, "exploring our sexuality" and condoning all manner of sexual perversity, and now we are seeing an unprecedented increase in STDs worldwide, and science is "discovering" that promiscuity reduces human fertility. DUH!
Charles Miller, Kings Mountain, NC
Who cares? God told people to behave themselves and they won't listen. So why should anyone who is monogamous and faithful to God's law care about what hedonistic people have to suffer after they were warned, especially when the first thing they do when they get sick is to demand coverage using tax dollars that the rest of us pay? Besides, the fact that a generation of complete losers can't breed successfully is an excellent thing for the planet and the rest of us anyway!
Bill Maher, Playboy Mansion, Holmby Hills, California USA