Male Fertility in the Context of Chronic Prostatitis: Mechanisms and Clinical Implications
DOI: 10.22591/magyurol.2025.4.kopazs.169
Authors:
Kopa Zsolt dr.
Semmelweis Egyetem, Urológiai Klinika, Andrológiai Centrum, Budapest
Summary
Introduction: The chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the most prevalent urological disorders in men, affecting approximately one quarter of all male urology patients. Beyond pain and voiding dysfunction, CPPS may significantly impair fertility through inflammatory, hormonal, and oxidative mechanisms.
Results: Proinflammatory cytokines such as IL-6 and TNFa induce mitochondrial dysfunction and oxidative stress, resulting in reduced semen volume, sperm concentration, motility, and morphology, as well as increased DNA-fragmentation. Hormonal dysregulation and impaired prostatic secretion further compromise spermatogenesis. Plant-derived therapies, particularly rye pollen extracts, and combination regimens with L-carnitine, tadalafil, and micronutrients have demonstrated improvement in semen parameters and clinical outcomes.
Conclusion: CPPS adversely affects male fertility via complex, multifactorial mechanisms. Multimodal, phenotype-oriented therapy integrating anti-inflammatory, antioxidant, and reproductive-supportive interventions may break the cycle of pain, inflammation, and infertility.