Association Between Exposure History, Antichlamydia Antibody Positivity, and Testicular Abnormalities in Azoospermic Male Infertile Patients

Background: Male infertility is a global concern, with azoospermia contributing to 10–15% of cases. Chlamydia trachomatis, a common sexually transmitted infection (STI), is linked to male infertility through inflammation, testicular damage, and impaired spermatogenesis. However, its association with exposure history, antichlamydia antibody positivity, and testicular abnormalities in azoospermic men remains underexplored. This study aimed to assess the prevalence of antichlamydia antibody positivity in azoospermic males and its association with exposure history (multiple sexual partners), hormonal disturbances, and testicular abnormalities. Methods: A cross-sectional study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from March 1, 2022, to February 28, 2023. A total of 64 azoospermic male patients were recruited through purposive sampling. Structured interviews assessed exposure history. Serological testing for IgG and IgA antichlamydia antibodies was performed using ELISA kits. Hormonal analysis (FSH, LH, testosterone, prolactin) and testicular ultrasonography evaluated endocrine and structural abnormalities. Statistical analysis was conducted using Chi-square and Fisher’s exact tests, with p < 0.05 considered statistically significant. Results: Antichlamydia antibody positivity was detected in 15.63% of patients. Those with multiple sexual partners had a significantly higher antibody positivity rate (50%) compared to those without such history (9%) (p = 0.002). Testicular abnormalities were more frequent in antichlamydia-positive patients (40%) than antibody-negative individuals (9.26%) (p = 0.015). No significant association was found between antibody positivity and hormonal disturbances (p = 0.07). Conclusion: This study highlights a strong link between exposure history and antichlamydia antibody positivity in azoospermic men. The high prevalence of testicular abnormalities in antibody-positive patients suggests ...