Herpes and infertility in men: what is the connection and what to do?

Herpes and infertility in men: what is the connection and what to do?

The connection between herpes viruses and male infertility is one of the most pressing and important problems in medicine today, given that about 40-60% of the adult population are infected with the herpes simplex virus (HSV). We are talking about the genital form, in which the disease manifests itself on the mucous membrane of the external and internal genital organs. In view of the urgency of the problem, we propose to study in more detail what is the connection between herpes and infertility in men .

Features of genital herpes in men

More recently, dermatovenerologists have been studying genital herpes. Over time, it became clear that in the case of men’s health, this problem also applies to urologists and andrologists.

In men, genital herpes has 2 clinical forms:

  • herpes of the upper part of the urogenital tract;
  • herpes of the lower genital tract, anus and rectal ampulla (located at the level of the sacrum).

In many cases, the only sign of genital herpes is the release of the virus in the discharge of the organs of the genitourinary system. At the same time, the symptoms of inflammation are minimal and nonspecific, and according to the results of analyzes, it is not even possible to identify objective signs that an inflammatory process is taking place in the body. All this underlines the difficulty of diagnosing genital herpes. Most often, it is detected by the typical clinical manifestations of relapses.

Influence of the herpes virus on reproductive function

In men diagnosed with infertility, in 31% of cases, infectious HSV is detected in the ejaculate and in 30% in the fraction of motile spermatozoa. The statistics for healthy patients are 17% and 8%, respectively. This proves that herpes is dangerous for men and directly affects the state of the reproductive system.

Patients with detected herpesvirus have:

  • decreased fertility;
  • violation of spermatogenesis (maturation of male germ cells);
  • a decrease in the proliferative activity (cell formation) of spermatogonia (spermatozoa are formed from them);
  • a decrease in the number of motile and normal sperm in shape;
  • exacerbation of chronic prostatitis;
  • blocking meiosis (cell division);
  • increased apoptosis (normal programmed cell death) of germ cells);
  • increased risk of spontaneous termination of pregnancy during natural conception due to the transfer of infected HSV sperm to the egg during fertilization.

In the process of examining men with HSV, it was found that the herpes virus is found not only in the semen and on the surface of cells, but also inside the sperm. Moreover, a fraction of spermatozoa with a normal structure and size is also exposed to infection. This suggests that fertilization of the egg can occur with an infected sperm. If we consider here what herpes affects in men, then it must be said that with successful conception there is a high risk that pregnancy will proceed with complications, the fetus and already a newborn child may develop various anomalies.

Viral prostatitis

The herpes virus can be the cause of the development of prostatitis. In most cases, the disease is caused by bacteria, but the abacterial (viral) form cannot be ruled out either. According to various experts, HSV causes or supports the development of prostatitis in 2.9-21.8% of cases.

Prostatitis develops as a complication of viral urethritis, i.e. lesions of the urethra, which most often occurs through sexual contact. From the urethra, the virus enters the prostate gland, that is, the urethrogenic canalicular transmission pathway predominates in the development of prostatitis – from the urethra along the vas deferens.

The disease can manifest itself in an isolated form. Then HSV is not detected in the discharge of the urethra, and there are no recurrences of herpes. In this case, the virus is found in the secretion of the prostate gland. This is important, since the identification of the pathogen is one of the decisive conditions for a full-fledged treatment.

Another sign of viral prostatitis is pronounced fibrous foci in the peripheral zones of the prostate gland. They are found on ultrasound as hyperechoic areas with a size of 3-9 mm. This is a characteristic feature that distinguishes herpetic prostatitis from other abacterial forms of the disease.

How infertility manifests itself and how it is treated

As already mentioned, herpes and infertility in men have a direct connection. The problem with conception due to herpesvirus manifests itself in the form of virusospermia. This is one of the types of pathospermia – pathological changes in the ejaculate, in which various deviations from normal values are observed.

Herpes simplex virus is a lifelong carrier. Therefore, infertility treatment is aimed only at achieving a stable remission, which will make it possible to achieve pregnancy and the birth of a healthy child. For this purpose, men who have been diagnosed with HSV in the secret of the prostate and diagnosed with viral spermia are prescribed antiherpetic drugs. They are taken according to a suppressive scheme, that is, there are no relapses only during the course of admission. To achieve normalization of sperm quality, the drug is taken for at least 2.5-3 months.

What is the bottom line

Due to the fact that genital herpes and infertility have a direct connection, in couples where pregnancy is planned or there are problems with conception, a man needs to undergo a virological examination. This is important because asymptomatic HSV infections of the genitourinary system are more common than commonly believed.

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