OBJECTIVE To understand the prevalence of pathogens causing genital tract infections among the infertile patients so as to provide bases for clinical diagnosis, treatment and prevention.

METHODS A total of 54, 562 infertile patients who were treated in Reproductive Medicine Center of Tang Du Hospital of Air Force Medical University from Jul. 2023 to Jan. 2025 were enrolled in the study. The cervical swab samples were collected from the female patients, and the urine samples were collected from the male patients. Chlamydia trachomatis (CT), Ureaplasma urealyticum (UU), Mycoplasma genitalium (MG) and Neisseria gonorrhoeae (NG) were tested by real-time fluorescent nucleic acid isothermal amplification for RNA. The statistical analysis was performed based on the gender, age and type of infection.

RESULTS The total positive rates of UU, MG, CT and NG were 38.36%, 2.85%, 0.99% and 0.04%, respectively. The patients with CT plus MG infection were dominant among the patients with mixed infections. The positive rates of UU and CT of the female patients were higher than those of the male patients (P < 0.001), while the positive rate of NG of the female patients was lower than that of the male patients (P=0.028). The patients aged more than 25 years old were susceptible to UU, with the positive rate highest among the patients aged between 35 and 40 years old. The patients aged less than 25 years old were dominant among the patients with MG and CT infections, and NG infection was more common among the patients aged between 25 and 35 years old. The positive rate of MG was higher among the patients aged less than 25 years old than among other age groups of patients (P < 0.005); the positive rate of MG was higher among the patients aged between 35 and 40 years old than among the patients aged between 30 and 35 years old (P < 0.005). The positive rate of CT was higher among the patients aged less than 25 years old than among all the age groups except for the 25 to 30 age group; the positive rate of CT of the patients aged no less than 40 years old was lower than that of the patients aged between 25 and 35 years old(P < 0.005).

CONCLUSIONS UU is most common among the pathogens causing genital tract infections among the infertile patients. There are a variety of types of mixed infections. The female patients are more likely to have UU and CT infections, while the male patients are more likely to have NG infection. MG and CT infections shows a low-age trend. It is necessary to focus on the joint screening of multiple pathogens during the clinical diagnosis and treatment and strengthen the prevention and intervention to the susceptible population.