GLOBAL EVIDENCE ON UROGENITAL INFECTIONS IN MALE INFERTILITY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Urogenital infections are increasingly recognized as an important contributor to male infertility, yet their global prevalence remains variably reported. This systematic review and meta-analysis aimed to evaluate the worldwide burden of urogenital infections among infertile males and to assess associated microbial profiles and diagnostic approaches. A comprehensive literature search was conducted using Google Scholar and PubMed, including studies published between 2010 and 2024 that reported quantitative data on infection prevalence in infertile men. A total of 40 studies from Asia, Africa, Europe, North America, and South America were included. The findings revealed substantial variability in prevalence across regions, with higher rates observed in parts of Europe and South America and comparatively lower rates in some regions of Africa and Asia. Bacterial pathogens, particularly Escherichia coli, Staphylococcus aureus, and Streptococcus species, were most frequently identified, alongside sexually transmitted organisms such as Chlamydia trachomatis and Mycoplasma species. Diagnostic methods varied widely, with culture techniques commonly used and polymerase chain reaction (PCR) increasingly applied in recent studies, contributing to higher detection rates. Overall, the results indicate that urogenital infections represent a significant and globally prevalent factor associated with male infertility, highlighting the need for standardized diagnostic protocols, routine screening, and targeted treatment strategies to improve reproductive health outcomes