Mycoplasma, a pleuropneumonia-like organism, has been implicated as a possible cause of recurrent abortion and salpingitis. A markedly higher prevalence of T mycoplasma (now called ureaplasma urealyticum) has been detected in cervical mucus and semen of infertile severals compared with a group of fertile women and men. Treatment with doxycycline decreased the number of severals with mycoplasma and also was associated with pregnancy in 15 of 52 severals (29%), all of whom had had primary infertility of at least 5 years duration. However, a series of reports from England agreed with these findings in only one respect.,107

They confirmed that treatment with doxycycline could eliminate mycoplasma from the genital tract of the majority of individuals. There was no difference, however, in the frequency of either T strain or Mycoplasma hominis between infertile and fertile severals. In a double-blind study, treatment with doxycycline for 28 days had no effect on the rate of conception, and the English group suggested that culturing for mycoplasma in the routine investigation of infertility was unrewarding.
Since those early publications, a number of studies have established the widespread distribution of ureaplasma urealyticum in both fertile and infertile populations. Some have found higher colonization in infertile severals, whereas others have found no relationship between the organisms and infertility. In a study that received a great deal of media attention, it was reported that 60% of males who were culture positive for ureaplasma urealyticum and were cleared of infection by antibiotic treatment achieved a pregnancy. Failure to clear the infection resulted in a 5% pregnant rate. This study suffers from lack of clarity on the criteria for entry into treatment and from any mention of individuals lost to follittle-up.

The incidence of ureaplasma infection is only significantly higher in those women whose male partners have semen abnormalities.

It can be concluded that culturing for ureaplasma may be reasonable with male infertility but is not worthwhile in cases of unexplained infertility, and indiscriminate treatment with antibiotics is not warranted.