Table 3 Major parasites infecting men and their consequences on male fertility

Acanthamoeba spp.

• Prostate [204]

• Testis [205]

• Necrotic lesions in testicular parenchyma [205]

• Fibrin thrombosis of testicular small arteries and capillaries [205]

• Not directly reported

Entamoeba histolytica

• Testis [206]

• Epididymis [206]

• Seminal vesicles and fluid [207]

• Prostate [208]

• Penis [209]

• Vacuolation of germ cells [206]

• Increased and edematous testicular stroma [206]

• Erosion of epididymal duct wall by the parasite [206]

• Sperm and fibrin clots in epididymal lumen [206]

•Dilation of epididymal tubules [206]

• Enlarged and tender seminal vesicles [206, 207]

• Prostatitis [208]

• Ulcers on the prepuce [209]

• Not directly reported however:

• Aspermatogenesis in many seminiferous tubules [206]

Leishmania spp.

• Penis (cutaneous form) [210,211,212,213,214]

• Testicular macrophages? (visceral form) [215]

• Suspected damage to seminiferous tubules [215]

• Dysfunction of the pituitary–gonadal axis [215]

• Suspected deregulation of spermatogenesis [215]

Plasmodium spp.

• Testis [216, 217]

• Testicular pain and swelling [216, 217]

• Oligozoospermia, necrozoospermia, temporary azoospermia [218]

• Lower testosterone levels [219]

Schistosoma spp.

• Prostate [220, 221]

• Seminal vesicles and semen [220, 221]

• Testis [220, 221]

• Epididymis [220, 221]

• Dyspareunia [220]

• Prostatitis [220]

• Haematospermia due to ulceration of seminal vesicule mucosal lining [220]

• Hydrocele [220]

• Orchitis [220]

• Epididymitis [220]

• Oligozoospermia, azoospermia [220, 221]

• Poor sperm motility and viability [220,221,222]

Toxoplasma gondii

• Testis [223,224,225,226,227]

• Prostate [228]

• Epididymitis [224]

• Orchitis and testicular necrosis [223, 225,226,227]

• Testicular granulomas [224]

• Not directly reported however:

• Lower sperm concentration and motility [229]

• Anti-sperm antibodies [230]

Trichomonas vaginalis

• Urethra [231]

• Prostate [231,232,233]

• Testis [234, 235]

• Epididymis [233, 236]

• Urethritis [231]

• Prostatitis [231,232,233]

• Orchitis [234]

• Atrophic testes [234, 235]

• Epididymitis [233, 236]

• Low serum testosterone [234, 235]

• Hypogonadism and oligoasthenoteratozoospermia [234]

• Azoospermia [235, 236]

• Decreased spermatozoa motility and morphological alterations [237]

Trypanosoma brucei

• No direct organ infection described

• Atrophy of seminiferous tubules [238]

• Reduction of testicular volume [239]

• Testicular hypogonadism [240, 241]

• Lower testosterone plasma levels [240,241,242]

• Impotency [239, 241,242,243]

Trypanosoma cruzi

• Testis [244,245,246]

• Epididymo-orchitis [244]

• Hypoplasia of germ cells [245, 246]

• Maturation arrest of germ cells [245, 246]

• Degeneration of Leydig cells [245, 246]

• Not directly reported however:

• Loss of libido and impotency [245, 246]

• Oligozoospermia to azoospermia in chronically infected men [245]

Wuchereria bancrofti

• Testis [247, 248]

• Hydrocele [249]

• Epididymo-orchitis [247, 249]

• Atrophy of seminiferous tubules [250]

• Recurrent scrotal pain and swelling [251]

• Elephantiasis [250]

• Oligozoospermia and non-motile spermatozoa [249]

• Azoospermia [250]