Relationship of the Gut and Genitourinary Tract Microenvironment and Male Fertility
University of Illinois at Chicago
Summary
Although much is known about the microenvironment of the gut and the vagina, very little has been published on the microenvironment of the seminal plasma. The seminal plasma is the support fluid for sperm, providing nutrients, facilitating sperm transit to the uterus, and promoting fertilization. It is a rich area of research for markers of fertility and treatment targets. The investigators hypothesize that (1) there are significant populations of seminal microorganisms associated with seminal leukocyte counts well below the WHO's cutoff for pyospermia (1 million/mL) that were not previously detected by traditional culturing methods, and (2) there are pathologic populations of bacteria within the gut and semen microbiome which negatively impact overall fertility, by directly or indirectly impairing hormone status. Participants will be recruited from the Male Fertility practice at the University of Illinois-Chicago (UIC). All participants will have infertility, diagnosed as an inability to conceive pregnancy after 12 months of unprotected intercourse. The normal evaluation of these participants is to obtain at least one semen analysis and bloodwork investigating their endocrine profile: total testosterone, estradiol, sex hormone binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and albumin. Semen volume is typically \>1 mL, and \<0.2 mL is typically used for the semen analysis. If over 1 million/mL round cells are identified, then a Papanicolaou stain would be performed to identify leukocytes. In this study, any semen demonstrated to have round cells would undergo Papanicolaou staining. A portion of the remaining semen, which would typically be discarded, will be sent for microbiome analysis. Secondly, as part of routine care, fertility patients may be started on medications to increase endogenous testosterone (i.e.: clomiphene citrate, anastrozole, etc). Participants started on medications will also be asked to submit a rectal swab for gut microbiome analysis. Routine care is to monitor the hormonal and testicular response with periodic endocrine blood panels and semen analyses; rectal swabs will be requested at these follow-up intervals also. The control group for both hypotheses will be men with clinical infertility with normal semen analyses and hormone profiles.
Description
Objectives: 1. Characterize the microbiota of the genitourinary tract and testicular microenvironment in infertile men with leukocytes in the semen by using 16S rRNA sequencing to analyze the microbiome of de-identified semen samples, and compare the results of semen with normal parameters to the results of semen with leukocytes. 2. Evaluate the influence of the gut microbiome on hormone replacement therapy in hypogonadal, infertile men who are being treated with hormone replacement therapy, by analyzing multiple de-identified blood samples and rectal swabs collected both before and over the…
Eligibility
- Age range
- 18+ years
- Sex
- Male
- Healthy volunteers
- Not specified
Inclusion Criteria: * Men diagnosed with infertility who consent to participate in the study Exclusion Criteria: * Prior hormone replacement therapy * Antibiotic use in past 6 months * Inability to consent for self, due to age or mental capacity * Infertility attributable to identifiable causes other than hypogonadism
Interventions
- DrugHormone replacement therapy
A hormone replacement regimen using any medication of a number of standard treatment options
Location
- University of Illinois HospitalChicago, Illinois