Infertility

Tubal Infertility

Trichomonas vaginalis as Risk Factor for Tubal Infertility
Study Population Infertility Risk vs. Control
Sherman (1987)3 Women with T. vaginalis 1.4 (1.0-2.5)
Sherman (1988)4 Women with history
of T. vaginalis		 1.7(0.8-3.6)
Grodstein (1993)5 Women with T. vaginalis 1.9 (1.3-2.8)
Women with 2-4 episodes 2.5 (1.4-4.6)
Women with > 4 episodes 6.2 (2.3-16)

Table 1

Trichomonads may serve as vectors for spreading other organisms by carrying these pathogens up the fallopian tubes.1 Several studies have shown Trichomonas vaginalis to be a risk factor for tubal infertility, as summarized in Table 1.

A recent study of 280 patients found that complaints of discharge, itching, dysuria and dyspareunia were higher among 240 infertile women than a control group of 40 pregnant women. In addition to these symptoms, culture positive T. vaginalis infection was also higher among the infertile women (14.6%) as compared to the pregnant controls (2.5%).2

T. vaginalis as a factor in male infertility

Trichomoniasis may contribute to male infertility by altering the motility and viability of sperm.

In 1977, Tuttle reported finding decreased sperm motility in the presence of Trichomonas, and that abnormalities in sperm motility and morphology improved after treatment of Trichomonas.6

Semen Parameters of Trichomonas Infected Males
Before and After Metronidazole Treatment7

Bar graph showing the motility and viability of sperm in the semen of men infected with tricmononiasis before and after treatment with metronidazole. Motility is 33 percent before treatment and 58 percent after. Viability is 62 percent before treatment and 72 after.

Trichomonads have been isolated from approximately 10% of infertile men in some studies.

In 1990, Gopalkrishnan compared the semen of T. vaginalis infected males with that of non-infected males among men enrolling in an in vitro fertilization program. Trichomoniasis was found in 50 of 1,131 men (4.2%), and there was a sizeable decrease in sperm motility (p<0.001) and viability (p<0.01) in T. vaginalis infected individuals. Significant improvements in sperm motility and viability were seen among 25 infected men subsequently treated with metronidazole.7

It is possible that infertility in asymptomatic individuals is a result of T. vaginalis infection, but it is uncertain if fertility is restored in treated individuals. Trichomoniasis in men can lead to morbidity, thus providing a rationale for more diligent diagnosis and treatment.7

  1. Keith LG, Friberg J, Fullan N, Bailey R, Berger GS. The possible role of Trichomonas vaginalis as a "vector" for the spread of other pathogens. Int J Fertil. 1986 Sep-Oct;31(4):272-7.
  2. El-Shazly AM, El-Naggar HM, Soliman M, El-Negeri M, El-Nemr HE, Handousa AE, Morsy TA. A study on Trichomoniasis vaginalis and female infertility. J Egypt Soc Parasitol. 2001 Aug;31(2):545-53.
  3. Sherman KJ, Daling JR, Weiss NS. Sexually transmitted diseases and tubal infertility. Sex Transm Dis. 1987 Jan-Mar;14(1):12-6.
  4. Sherman KJ, Chow WH, Daling JR, Weiss NS. Sexually transmitted diseases and the risk of tubal pregnancy. J Reprod Med. 1988 Jan;33(1):30-4.
  5. Grodstein F, Goldman MB, Cramer DW. Relation of tubal infertility to history of sexually transmitted diseases. Am J Epidemiol. 1993 Mar 1;137(5):577-84.
  6. Tuttle JP Jr, Holbrook TW, Derrick FC. Interference of human spermatozoal motility by trichomonas vaginalis. J Urol. 1977 Dec;118(6):1024-5.
  7. Gopalkrishnan K, Hinduja IN, Kumar TC. Semen characteristics of asymptomatic males affected by Trichomonas vaginalis. J In Vitro Fert Embryo Transf. 1990 Jun;7(3):165-7.
Sponsored by Tindamax (tinidazole)