{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T02:38:34Z","timestamp":1785292714297,"version":"3.55.0"},"reference-count":64,"publisher":"Pensoft Publishers","issue":"2","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>\n                    <jats:bold>Background<\/jats:bold>\n                    : Sexually transmitted infections (STIs) have been linked to male infertility; however, the available evidence from Eastern Europe is inconclusive.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Aim<\/jats:bold>\n                    : The present study therefore set out to assess the prevalence and etiology of STIs, focusing on\n                    <jats:italic>Trichomonas vaginalis<\/jats:italic>\n                    , among infertile Bulgarian men.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Materials and methods<\/jats:bold>\n                    : A retrospective monocentric study was conducted at Thorax Hospital, Plovdiv, between May 2018 and May 2024, on 359 infertile and subfertile men. The study adhered to the World Health Organization (WHO) guidelines for the evaluation of semen parameters. Ejaculate, prostatic secretions and urethral swabs were subjected to a culture and microscopy procedure for 16 pathogens. The associations between semen quality and these parameters were examined using t-tests, chi-squared tests and logistic regression.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : Sexually transmitted infections were detected in 48.5% (174\/359). Frequent pathogens were\n                    <jats:italic>Ureaplasma urealyticum<\/jats:italic>\n                    (29.5%), group B streptococcus (25.1%),\n                    <jats:italic>Enterococcus<\/jats:italic>\n                    spp. (13.9%), and coagulase-negative staphylococci (CoNS) (13.9%). The prevalence of\n                    <jats:italic>T. vaginalis<\/jats:italic>\n                    was 6.7% (24\/359) and associated with lower progressive motility (\u03b2=\u22127.66 percentage points;\n                    <jats:italic>p<\/jats:italic>\n                    =0.028, uncorrected). Coinfections occurred in 42.1%, monoinfections in 39%. Prostatic secretions were more often positive than ejaculate (54.7% vs. 46.9%;\n                    <jats:italic>p<\/jats:italic>\n                    =0.06). No significant between-group differences were seen for sperm concentration (43.9 vs. 46.7 million\/mL,\n                    <jats:italic>p<\/jats:italic>\n                    =0.307) or symptoms (21.3% vs. 27.6%,\n                    <jats:italic>p<\/jats:italic>\n                    =0.206). Multivariable models found no independent clinical predictors (all\n                    <jats:italic>p<\/jats:italic>\n                    &amp;gt;0.05), while pathogen burden correlated with motility (r =\u22120.152,\n                    <jats:italic>p<\/jats:italic>\n                    =0.004).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion<\/jats:bold>\n                    : Sexually transmitted infections (STIs), particularly\n                    <jats:italic>U. urealyticum<\/jats:italic>\n                    and\n                    <jats:italic>T. vaginalis<\/jats:italic>\n                    , are common in infertile Bulgarian men and often remain asymptomatic. Routine broad-spectrum screening, including prostatic sampling, is warranted to detect treatable causes and potentially optimize fertility outcomes. Prospective studies should determine whether the eradication of these infections improves semen quality. These findings emphasize the necessity for standardized, comprehensive diagnostics and meticulous interpretation of colonizers versus pathogens in infertility evaluations to inform management decisions.\n                  <\/jats:p>","DOI":"10.3897\/folmed.68.e172980","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:42:03Z","timestamp":1775148123000},"source":"Crossref","is-referenced-by-count":1,"title":["Etiological spectrum of sexually transmitted infections in infertile men: a monocentric retrospective study"],"prefix":"10.3897","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6358-2592","authenticated-orcid":true,"given":"Blagovest","family":"Petrov","sequence":"first","affiliation":[{"name":"Department of Urology and General Medicine, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1414-8738","authenticated-orcid":true,"given":"Kostadin","family":"Kostadinov","sequence":"additional","affiliation":[{"name":"Environmental Health Division, Research Institute at Medical University of Plovdiv, Plovdiv, Bulgaria"},{"name":"Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Dechev","sequence":"additional","affiliation":[{"name":"University Hospital \"Saint George\", Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krasimira","family":"Eneva","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Parasitology and Tropical medicine, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2258","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"172980_B1"},{"key":"172980_B2"},{"key":"172980_B3"},{"key":"172980_B4"},{"key":"172980_B5"},{"key":"172980_B6"},{"key":"172980_B7","unstructured":"Ghosh S, Ghosh D. Current perspectives of male infertility induced by immunomodulation due to reproductive tract infections. Chem Biol Lett 2020; 7(2):85\u201391."},{"key":"172980_B8"},{"key":"172980_B9"},{"key":"172980_B10"},{"key":"172980_B11"},{"key":"172980_B12"},{"key":"172980_B13"},{"key":"172980_B14"},{"key":"172980_B15"},{"key":"172980_B16"},{"key":"172980_B17"},{"key":"172980_B18","doi-asserted-by":"crossref","unstructured":"Cheng C, Chen X, Song Y, et al. Genital mycoplasma infection: A systematic review and meta-analysis. Reprod Health 2023; 20. doi: org\/10.1186\/s12978-023-01684-y","DOI":"10.1186\/s12978-023-01684-y"},{"key":"172980_B19"},{"key":"172980_B20"},{"key":"172980_B21","doi-asserted-by":"crossref","unstructured":"Liu L-B, Yang W, Chang J-T, et al. Zika virus infection leads to hormone deficiencies of the hypothalamic-pituitary-gonadal axis and diminished fertility in mice. J Virol 2023; 97. doi: org\/10.1128\/jvi.01006-23","DOI":"10.1128\/jvi.01006-23"},{"key":"172980_B22"},{"key":"172980_B23"},{"key":"172980_B24"},{"key":"172980_B25"},{"key":"172980_B26"},{"key":"172980_B27"},{"key":"172980_B28"},{"key":"172980_B29"},{"key":"172980_B30"},{"key":"172980_B31"},{"key":"172980_B32"},{"key":"172980_B33","unstructured":"Nikolova V, Vatev I, Stanislavov R, et al. [Selecting function of female genital tract in relation with spermatozoa interaction]. Akusherstvo i Ginekologiia 2006; 45(7):47\u20139. PMID: 17489168 [Bulgarian]."},{"key":"172980_B34","unstructured":"Stanislavov R, Chernev T, Nikolova V, et al. [Asymptomatic infections of the genital tract and infertility]. Akusherstvo i Ginekologiia 2000; 39(1):18\u201320 [Bulgarian]."},{"key":"172980_B35"},{"key":"172980_B36"},{"key":"172980_B37","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-3993380\/v1"},{"key":"172980_B38"},{"key":"172980_B39"},{"key":"172980_B40"},{"key":"172980_B41"},{"key":"172980_B42"},{"key":"172980_B43"},{"key":"172980_B44"},{"key":"172980_B45","unstructured":"The European committee on antimicrobial susceptibility testing (EUCAST) 2025."},{"key":"172980_B46","unstructured":"Clinical and laboratory standards institute (CLSI) 2025."},{"key":"172980_B47","unstructured":"R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2024. Available from: https:\/\/www.R-project.org\/."},{"key":"172980_B48","doi-asserted-by":"publisher","DOI":"10.21105\/joss.01686"},{"key":"172980_B49"},{"key":"172980_B50"},{"key":"172980_B51","unstructured":"Dechev I, Chokova N, Mateva N. 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