Ureaplasma and female and male fertility

Mycoplasmas are a controversial behavior: most are commensal, i.e. they are part of the normal microbiota, others are real pathogens, still others are parasites only in particular circumstances.

Recall that  the human microbiota consists of trillions of tiny cells that live in and on the human body. These tiny organisms help digest food, fight infection, and maintain reproductive health.

Of the approximately 200 known species of mycoplasmas, only 6 have a pathogenic role in humans, certain or presumed, 5 of which reside in the urogenital system:

  • Mycoplasma of man
  • Mycoplasma genitalia
  • Micoplasma fermentans
  • Ureaplasma urealyticum
  • Ureaplasma minor

In addition to genital tract infections and infertility, ureaplasma infections are associated with adverse pregnancy outcomes and some pathologies of the newborn.

Ureaplasma is very small in size and does not have a cell wall, making it unique among bacteria. The lack of a cell wall makes it resistant to some common antibiotics.

Timely diagnosis and initiation of appropriate antibiotic therapy are essential to prevent long-term complications of ureaplasma infections.

In this article, we look at how ureaplasma spreads, the symptoms it can cause, and what treatment options are available.


Ureaplasma can cause fertility problems for both men and women.
Ureaplasma can be transmitted during sexual contact.

These bacteria can also be passed to a fetus or infant if the mother contracted the ureaplasma infection during pregnancy.

Finally, according to one study, ureaplasma infections can also be found in women who have never been sexually active.

Therefore, the cause of the presence of ureaplasma infection is not always known.


Most people infected with ureaplasma have no symptoms . However, ureaplasma infection is a possible cause of urethritis .

Urethritis is manifested by:

  • pain when urinating
  • burning sensation
  • losses

Ureaplasma is also a possible cause of bacterial vaginosis . Symptoms can include:

  • watery vaginal discharge
  • unpleasant vaginal odor

Ureaplasma has been linked to additional health problems that can cause pain in the pelvic, abdominal or groin area. These include:

  • Prostatitis : inflammation of the prostate gland. Prostatitis can cause pain when urinating, cloudy or bloody urine, difficulty urinating, pain in the genital area .
  • Endometritis : Inflammation of the lining of the uterus. This can cause pelvic pain, abnormal vaginal bleeding or discharge, and fever. Endometritis can be caused by various bacteria.
  • Kidney stones : Ureaplasma in some people can play a role in the formation of kidney stones in some people

Ureaplasma and fertility

Ureaplasmas have been found in both men and women with infertility problems. Infertility is defined as the inability to conceive after at least 12 months of trying to conceive.

Ureaplasma was detected in 25.8% of patients with genital tract infections and 20.8% of infertile women.

However at the moment there are no conclusive studies that clarify the relationship between the presence of these bacteria and infertility.

Bacteria can affect sperm count and their ability to move in men. In women, it can cause an infection that makes pregnancy more difficult.

An estimated 15% of male infertility is related to genital tract infections .

Male genital tract infections are difficult to detect as they are asymptomatic in many cases and often remain undiagnosed unless the patient seeks treatment for specific symptoms.

However, in light of the growing number of patients seeking fertility treatment using assisted reproduction, the diagnosis of “silent” genital tract infections may be linked to asthenozoospermia.

Infections are therefore potentially treatable causes of male infertility.

One study found that Ureaplasma urealyticum is found more often in women with unexplained infertility. Consequently, the authors suggest that women with unexplained infertility should be tested for these infections.

One review found that ureaplasma urealyticum was associated with a higher risk of infertility in men while ureaplasma parvum was not linked to male infertility.

Colonization of the vagina or cervix with ureaplasmas can
lead to ascending infection of the upper genital tract (endometrium and fallopian tubes)
with subsequent inflammation of these structures. Long-lasting inflammation within the upper genital tract can cause scarring and contribute to infertility.

Ureaplasma also appears to play a role in the risk of preterm birth because it can cause inflammation of reproductive tissues.

The presence of ureaplasma has also been associated with an increased risk of postpartum endometritis, which is inflammation of the uterus.

How is it diagnosed?

Due to its small size, ureaplasma is nearly impossible to see under a microscope. Identification requires specialized laboratory equipment and testing.

The most common ways for a diagnosis are:

  • cervical swab
  • endometrial biopsy
  • spermiocultura

What are the treatment options?

Treatment depends on the woman’s health status. Under normal conditions, a course of antibiotics is usually expected. The antibiotics selected for a ureaplasma infection are azithromycin or doxycycline. If it doesn’t respond to treatment, your doctor may prescribe other types of antibiotics, erythromycin or gatifloxacin.

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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