Today the most important issue is problem of compatibility of cytomegalovirus and HIV infection.

When immunity decreases (which often occurs in people with AIDS), cytomegalovirus may become so active that may damage all organs and systems in the body, and even cause development of oncological diseases.

Immunodeficiency disorders may appear after radiotherapy and chemotherapy in patients who used those treatments for their cancer, or after admission high doses of corticosteroids, or may result from immunoreduction therapy after organ transplantation.

Cytomegalovirus presents a true danger for pregnant women because cytomegaly may cause miscarriage or dead birth.

In later terms, the disease may cause severe birth defects or disorders found after birth in a baby such as increased liver and spleen, hemorrhage in internal organs, symptoms of nervous system damage.

Therefore, women who plan pregnancy should undergo tests on  cytomegalovirus along with rubella, toxoplasmosis and herpes.

External appearance of cytomegalovirus is similar to herpes viruses which cause genital virus and lip sore. Cell affected by cytomegalovirus has a large size and contains typical large inclusion bodies. Due to this specific look the disease was called cytomegalovirus (from the Greek cyto-, “cell”, and -megalo-, “large”).

In 1956 first was proved that cytomegalovirus disease is transmitted not only via saliva but also during sexual intercourse, during pregnancy from mother to baby. Also are known cases when people get infected with cytomegalovirus during blood transfusion and organ transplantation.

Cytomegalovirus disease is very common, however, many virus carriers are unsuspicious of its existence in their body. First of all, it is related to cases when virus not shows any clinical symptoms. Often cytomegalovirus lives in human body whole his life without showing itself and without having negative effects over the body.Sometimes cytomegalovirus shows with symptoms of an ordinary cold and in this case people diseased with it may transmit the virus to other people via close contacts with them.

Most adults and significant number of children are infected with this virus. Cytomegalovirus is most common in developing countries where living standards are low, and poor social and hygienic conditions make the virus spread more quickly.

Today to detect pathogen are used more precise methods of investigation, for example, polymerase chain reaction (PCR) and bacterial inoculation.

Also immunoenzyme methods are widely used. However they are charaterized with low precision (nearly 50 – 70%). Detection of antibodies to Ureaplasma parvum and Ureaplasma urealyticum are limited in ureaplasmosis diagnistics.

Treatment
When ureaplasmosis is found in a man, his sexual partner should also undergo treatment even if the partner has no complaints. It should be done because sexual partner may be a reservoir of infection, which may lead to repeated infecting of the man who got treated from it.
There are two directions in ureaplasmosis treatment;
1) treatment with antibacterial medications with account of sensitivity to ureaplasmas
2) correction of immune system disorders. There was proved slight effectiveness of isolated antibiotic therapy
The last stage in ureaplasmosis treatment is obligatory regeneration of vaginal normal flora in a woman.

Prevention
When ureaplasmas are found, it is necessary to say about it to both partners even if they do not experience any symptoms. They both should undergo general examination and treatment if necessary.

Both partners should undergo examination if they plan pregnancy. Taking into account the possibility of misbirth or premature delivery, it is necessary to get rid of ureaplasmas preliminarily.

It is proved that ureaplasmas have negative effects on male reproductive function. Studies showed that ureaplasmas may attach to sperm cells and break their motion activity, and in some cases even destroy sex cells.

Ureaplasmosis may course in acute or chronic form. As other infections, the disease has no symptoms specific for this pathogen. Ureaplasmosis signs depend on the organ it has damaged. At the same time, modern methods of examination find ureaplasmosis in healthy women who experience no disease manifestations and frequently it goes with other ingections.

Ureaplasmas may cause inflammation of any part of urogenital tract: urethra, prostate, bladder, testes and their adnexa – in males; vagina, alvus and its adnexa – in females.

Ureaplasmosis shows its symptoms in 3 – 5 weeks after infecting. It should be noticed that patients experience non-significant symptoms, and frequently they do not feel any symptoms at all (especially women).

Ureaplasmosis symptoms in males:

• poor liquid discharge from urethra
• moderate pains and itching during urination
• prostatitis symptoms when prostate gland is affected

Some scientists consider it a transition stage from virus to bacteria.

Ureaplasmas are opportunistic pathogens, which means they may cause the disease in particular circumstances, but normally they live on mucosa of genitals and urinary tract of a human and he experiences no symptoms at all.

Ways of transmission
Transmission of infection occurs via sexual intercourse, however, is possible transplacental infection from infected mother, and besides this, microbes may get into baby genitalia during birth and live there all his life in dormant state. Community-acquired infection is impossible. 70% people who have  ureaplasmas in their body do not experience any specific sensation.

Some people experience unpleasant sensations periodically – sometimes they appear and sometimes they disappear. However, deficiency of symptoms does not mean that ureaplasmas has no harmful effects on the body. Only 10% women normally  have ureaplasma in their vagina which does not require treatment. In other cases ureaplasmosis is risk factor, and sometimes it causes severe pathology of female genitalia, pregnancy troubles and birth complications. Ureaplasmas are found on genitalia in each third newborn girl.

In boys ureaplasmas are found much rarely due to genitalia anatomy – boys genitalia are protected during passage through birth canal of mother. Frequently children infected with ureaplasmas during birth get self-recovered after some time. Most often this occurs in boys. In people who are active sexually, the incidence of  ureaplasmosis is higher which is connected with infecting during sexual intercourses. 50% of women are carriers of ureaplasmas. Among men the ratio is much lower.

Clamidiosis treatment is complex and should include medications directed against pathogen and medications helping immune system to fight the infection.

Today for Clamidiosis treatment are used combination of antibacterial therapy (modern antibiotics acting within the cells), immunomodulatory therapy and lifestyle change.

During treatment patients are recommended to refuse from sex and alcohol. Multivitamin preparations and diet help to treat Clamidiosis more quicker.

After Clamidiosis treatment during several months patients should undergo examinations: females during 1 – 2 menstrual cycles, males – 3 -4 months.

Clamidiosis is a veneral disease and both partners should treat it, otherwise persists high risk of reinfection.

Prevention
Clamidiosis frequently courses without symptoms, therefore people from risk groups (frequent change of sex partners, sex without using barrier methods of contraception) should undergo examinations on Chlamydia infection regularly. It is very important to do that because early recognition and timely started Clamidiosis treatment provides much effective treatment results and improves prognosis.

The prognosis in case of timely started treatment is favorable.  Using modern anti-bacterial medications  and immunostimulants helps to succeed full recovery in 95% cases.

There are two forms of  clamidiosis: acute and chronic. Acute form of clamidiosis is characterized with mild course, without damaging lower parts of urogenital tract. Chronic form is characterized with spread of infection to upper parts of urogenital tract which frequently causes complications.

Regular examinations help to detect infection at early stages. Any diagnosis bases on the results of several methods of examinations. Goal seeking of pathogen usually starts after examination by the specialist (urologist, gynecologist, venereologist, andrologist).

For example, in case of female infertility , unprompted misbirths, cervical erosion, inflammatory diseases in genital tracts, severe course of past pregnancies, is prescribed complex of diagnostic maneuvers to find sexually transmitted infections including clamidiosis. In males major symptom which would make the doctor suspect clamidiosis is prostatitis and urethritis, condylomata urethra opening. Examination may be performed in patients who had casual sex.

Primary examination makes specialist. In case he finds damages in reproductive system, he may suspect clamidiosis and suggest patient to undergo advanced examination to detect and confirm provisional diagnosis.

Matter for the investigation in females is scrape from surface of uterine cervix, urinary tract, vaginal discharges. In males for the investigation is taken sperm. Commonly are taken blood and urine. Modern methods (for example, Polymerase Chain Reaction) help to affirm with high precision if chlamydia was found or not in the obtained matter, and based on that specialist says the diagnosis. Using all the data obtained, including primary examinations data, the specialist prescribes treatment.

Clamidiosis pathogen is Chlamydia trachomatis, which is a transitional form between bacteria and viruses. Chlamydia lives in a living cell like virus does, but has structure similar to bacteria. Such duplicity of nature makes this pathogen stand against immunity of infected person and resist the treatment.

Stages of Chlamydia life:
1. infectious stage, when it lives out of cell
2. reticular stage, when it lives in cell being a cell parasite

Chlamydia life circle equals two days. When chlamydias multiply in cells, they fill whole cytoplasm and destroy the cell. Then they emerge in intercellular space and enter other cells. Thus circle repeats over and over again.

Ways of infection transmission:
- sex
- baby infection during pregnancy
- baby infection through genitals during childbirth
There were rare cases of Chlamydia infection transmission via bed and body clothes.

What are the dangers of clamidiosis?
The danger of clamidiosis is that it courses without symptoms. Longtime unrecognized chlomydia in the body may lead to serious complications. In males clamidiosis results in prostate gland damage (prostatitis), seminal vesicles inflammation (vesiculitis), epididymis inflammation (epididymitis) , and even male infertility. Spreading through urinary tract, chlamydia causes cystitis. In females chlamydia causes  cervical ectropion, vaginitis. Often chlamydias enter salpinges where they cause inflammation development which then leads to cicatrical changes and results in female infertility.

Clamidiosis damages not only urogenital system in a man. Remaining in human body without treatment, chlamydias gradually spread through the whole body and damage internals and joints, and even eyes. Infected mother may become source of infection for her baby. Chlamydia may cause misbirth, non-developing pregnancy, etc. Intrauterine infection of fetus may cause multiple damage of internals. Often after birth in baby are revealed various pathologies caused by chlamydia.

Unfortunately, Clamidiosis may cause Reiter’s syndrome. This rare disease is characterized with simultaneous development of arthritis, conjunctivitis and urethritis (urinary tract inflammation). In some cases occurs skin inflammation. Those conditions appear after past chlamydia infection. Nature of the disease is not known yet. It is known that under influence of chlamydia may occur changes in immune system which leads to production of “false” antibodies directed against proper cells.

- ejaculotary dysfunction (breakdown of ejaculation process)
- immunological infertility
- oligozoospermia (low sperm count)

2) In vitro fertilisation
In this procedure ovums are taken from female egg after preliminary hormonal stimulation which then are fertilized with male sperm (sperm of husband or donor). Embryos are grown in incubator during 48 – 72 hours, then they are inserted into female alvus. The success of this type of fertilization depends on state of female endocrine system. Frequency of pregnancy is higher in cases where more than 5 eggs were fertilized with sperm.

3) Intra Cytoplasmic Sperm Injection (ICSI)
Chances of azoospermia correction are low. However, today was implemented technique of sperm injection directly in cytoplasm of ovum (ICSI). Here are used singular sperm cells of epididymal (taken from male epididymis) or testicular origin. Indications for ICSI:

• concentration of sperm cells is less than 10 mil. (2 mil. for ICSI)
• sperm motility less than 10% (5% for ICSI)
• more than 70% pathological forms of sperm cells (over 96% for ICSI)
• opportunity to get sperm cells only surgically
• failure of other methods of infertility treatment

The effectiveness of artificial insemination techniques is 30% after just one attempt. Using of assisted reproductive technologies do greatly increases facilities of correction of most severe forms of male infertility including azoospermia. Effective treatment of infertility is possible only when urologists, ginecologists and in vitro fertilisation specialists do interact. Patient must be informed enough about modern techniques of infertlity treatment.

However, blood circulation normalization, absence of sexually transmitted diseases, repair of  seminiferous paths (when is possible), elimination of production harms do not provide elimination of antisperm antibodies when they already started to reproduce themselves. Therefore, second stage requires usage of one or complex of additional treatments:

• medication therapy (systemic enzyme therapy, hormonal therapy)
• special washings with further intrauterine or intratubal insertion of spermal cells
• extracorporal fertilization including fertilization with single spermal cell using method of microinjection in plasma

Remember that any stimulating therapy is contraindicated to patients with aspartate transaminase. When patient or/and his partner have antispermal antibodies and no other pathologies, then the diagnosis of isolated immune infertility is made. In isolated immune infertility the nonsurgical empiric treatment is ineffective. The only real alternative here is assisted reproductive treatment.