The role of Ureaplasma spp. in the development of non-gonococcal urethritis and infertility among men

Abstract

Ureaplasma spp. are a genus of bacteria for which two human associated species exist; Ureaplasma urealyticum and Ureaplasma parvum. Their definition as a pathogen in the context of non-gonococcal urethritis and infertility among males remains highly controversial, largely due to historically high isolation rates of these bacteria from the urethra of seemingly healthy men. This review summarises the emerging evidence suggesting a true pathogenic role of these bacteria under specific conditions, which we term as risk factors. We examine the historical, clinical and experimental studies which support a causal role for Ureaplasma spp in the development of NGU as well as some of the proposed mechanisms behind the association of Ureaplasma spp. and the development of infertility. Finally, we discuss the potential for developing a case-by-case risk-based approach towards the management of men who present with seemingly idiopathic NGU, but are positive for Ureaplasma spp.