Have Ureaplasma urealyticum and Mycoplasma hominis infections any significant effect on female fertility? Ureaplasma urealyticum e Mycoplasma hominis svolgono un ruolo nella infertilità femminile?

Sexually transmitted diseases (STDs) act on genital systems and may affect female and male reproductive functions in three different ways, through the obstruction of either male or female reproductive ducts, a significant contribution to perinatal morbidity, mortality, and pregnancy wastage [1]. Ureaplasma urealyticum and Mycoplasma hominis are known as sexually transmitted agents. Although U. urealyticum and M. hominis are found in genital tract flora of many sexually active men and women who have no obvious clinical diseases or abnormalities [2], they have been associated with a variety of clinical conditions, including bacterial vaginosis, infertility, pelvic inflammatory disease (PID), premature birth and low birth weight infants, spontaneous abortion and stillbirth, chorioamnionitis, and postpartum infections [3-10]. U. urealyticum and M. hominis jeopardize male fertility [11, 12]. However, it is unclear whether these infections significantly contribute to female infertility. Some studies suggest that U. urealyticum and M. hominis may have potential adverse effects on fertility in women [13, 14], but in other studies there are controversial results which do not confirm a definitive pathogenic role for these agents in female infertility [15-17]. These organisms reduce the success rate of highly specialized infertility treatments including intrauterin artificial insemination (IUAI), gamet intrafallopian transfer (GIFT), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI) [18-21]. In this controlled study we aimed to establish whether M. hominis and U. urealyticum are risk factors for female fertility and evaluate the prevalence of infection from these agents in patients attending our infertility clinic.