Does chronic prostatitis affect fertility

Patient's question:

Prostate disease

Doctor's answer:

The issue of whether chronic prostatitis affects fertility cannot be generalized. Theoretically, the prostate is an accessory gland of the male reproductive system, and its secretion—prostatic fluid—is a component of semen. Inflammatory lesions inevitably affect the composition of semen and interfere with the activity and function of sperm, thereby impacting male fertility. In fact, scientists have indeed discovered changes in the physicochemical properties of semen from chronic prostatitis patients. Due to the influence of bacteria and bacterial toxins, the nutritional components of seminal plasma can be depleted, the pH (acidity/alkalinity) of semen can be altered, the activity of certain enzymes can be disrupted, the viscosity of seminal plasma can increase, sperm motility can be impaired, and the body may produce antisperm antibodies, all of which may affect male fertility.
However, clinically, it has also been observed that many men with chronic prostatitis for years, whose prostatic fluid frequently shows a full-field view of pus cells under the microscope, have not been affected in their fertility.
Severe chronic prostatitis may cause infertility in some men. This may be related to the following factors:
1. During prostatitis, the secretion volume of prostatic fluid may decrease, leading to a reduction in semen volume, which is unfavorable for sperm survival and motility. Additionally, due to a decline in the activity of active factors and an increase in coagulation factors in prostatic fluid, semen may appear gelatinous after ejaculation, prolonging liquefaction time and hindering normal sperm motility. These factors can all affect male fertility. In some cases of infertility, chronic prostatitis is a significant cause.
2. When suffering from prostatitis, the pH of semen often decreases, making it more acidic. When the pH drops to the minimum requirement for sperm (pH 6–6.5), sperm may die prematurely, disrupting normal reproductive processes and affecting fertility.
3. During chronic prostatitis, prostatic fluid often contains large amounts of bacteria, bacterial toxins, and inflammatory secretions. These harmful substances can deplete the nutritional components and oxygen in semen, thereby affecting sperm survival and causing male infertility. The relationship between chronic prostatitis and fertility has not yet been fully elucidated. However, it must be noted that most men with chronic prostatitis, despite the severity of inflammation, still have good fertility and normal sexual function. Moreover, chronic prostatitis is curable, and young men with the condition should not overworry.
Currently, China advocates for eugenics and optimized child-rearing, so it is generally recommended that men with chronic prostatitis wait until the condition is cured before reproducing, in order to improve the quality of the nation's population.