Amin Khoshakhlagh - Department of Microbiology, Islamic Azad University, Naein Branch, Isfahan, Iran
Reza Salman Yazdi - Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
Farah Taj Navab-Akbar - Department of Microbiology and Virology, Isfahan University of Medical Sciences,Isfahan, Iran
Farid Dadkhah - Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran

Background: Chlamydia trachomatis (CT) with damaging effects on sperm quality parameters can often cause infertility in men. The main objective of this study was todetermine the prevalence of CT infection in semen samples of both symptomatic and asymptomatic infertile men referring to Royan Institute, by using serological and molecular diagnostic methods. Materials and Methods: In this case-control survey, 465 patients referring to clinical laboratory of Royan Institute were randomly chosen for primary screening and detection of the presence of CT. Among which 93 samples were normozoospermia (Asymptomatic) and other 372 had abnormal parameters(Symptomatic) in semen analysis. ELISA test was performed as the screening test to trace the presence of anti-CT IgA in patients seminal plasma. 62 samples (32 symptomatic and 30 asymptomatic) with higher results in ELISA were selected as the case group and 34 asymptomatic samples with negative results randomly were selected as the control group for confirmatory test. The sperm DNA was extracted so as to confirm the presence of CT. PCR method was used to confirm the serological results by using particular primers for amplification of CT genome. Results: 62 out of 465 samples had OD> 0.200 in ELISA screening test and were selected as the case groups for molecular assay. 34 asymptomatic samples with OD<0.200 in ELISA test were selected as the control group for PCR, too. In the case groups, 4 out of 32 symptomatic samples (12.5%), and 1 out of 30 asymptomatic samples (3.3%) revealed positive in PCR. No PCR positive sample was observed in control group. Moreover, the comparison of two symptomatic and asymptomatic groups showed that there was no significant difference between the age (p=0.253) and the semen volume (p=0.447) of the patients. The final results revealed that the prevalence of CT in symptomatic and asymptomatic infertile patients with Iranian nationality were equal (1.075%). Conclusion: CT will result in pelvic inflammatory disease (PID) and infertility if it is not diagnosed and treated. Screening of infertile men who do not show any clinical symptoms look unavoidable and can be considered as a part of the program of sexually transmitted disease (STD) control. In conclusion the Anti-CT IgA ELISA test could be introduced as an appropriate tool for screening purpose in seminal plasma of infertile men.

Chlamydia trachomatis, Infertile Men, ELISA, PCR, Screening