How Does Chronic Prostatitis Lead To Infertility?
Male fertility is a complex process. To get your partner pregnant, the following must occur: You must produce healthy sperm. Initially, this involves the growth and formation of the male reproductive organs during puberty. Sperm have to be carried into the semen. Once sperm are produced in the testicles, delicate tubes transport them until they mix with semen and are ejaculated out of the penis. There needs to be enough sperm in the semen. Sperm must be functional and able to move.
The prostate gland is the walnut-sized gland that makes up part of a man's reproductive system. It secretes a fluid that contributes to the semen that sperm swim in. The term prostatitis refers to inflammation of the prostate gland. Unfortunately, chronic prostatitis is not so simple — and it’s a lot more common than acute prostatitis. It’s also more difficult to understand. Doctors tend to have trouble both diagnosing it correctly and treating it successfully. To add to the complexity, several studies have found a link between chronic prostatitis and fertility problems in men.
"Part of the confusion with chronic prostatitis and infertility is that what we call chronic prostatitis is not one but several different diseases," says Daniel Shoskes, MD, a urology specialist at the Cleveland Clinic in Ohio, "and not all types of chronic prostatitis cause infertility."
Infertility has been linked to the types of chronic prostatitis that cause white blood cells to mix with sperm. That means chronic bacterial prostatitis or asymptomatic inflammatory prostatitis, but probably not chronic pelvic pain syndrome," explains Dr. Shoskes.
White blood cells are part of the body's defense system that fights infection. Studies show that when these cells, also called leukocytes, are found in prostate secretions, they decrease sperm function, sperm quality, and fertility.
Doctors don't know exactly how white blood cells have this effect on sperm, but it may have something to do with molecules produced by white blood cells called reactive oxygen species. These molecules are part of the white blood cells’ disease-fighting properties. Studies show that reactive oxygen species are elevated in semen samples from up to 40 percent of infertile men.
"Another possible but rare cause might be scar tissue that forms from a long-standing bacterial prostatitis. Scar tissue might block sperm from getting into seminal fluid," notes Shoskes. "We just don't know the exact mechanisms, but we do know that white blood cells seem to secrete substances that inhibit sperm."
Shoskes says that chronic prostatitis is a rare cause of infertility, but one that may be reversible. "If chronic prostatitis is caused by bacteria, antibiotics may reverse the inflammation and the infertility. In cases where there are white blood cells without bacteria, there is some evidence that treatment with Diuretic and Anti-inflammation Pill can help.
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