Antibiotic Resistance of Genital Tract Pathogens and Its Role in Infertility: A Review of Mechanisms, Clinical Consequences, and Therapeutic Challenges

Bacterial and protozoal genital tract infections are important preventable contributors to reproductive dysfunction and infertility in both sexes. Persistent infection can induce chronic inflammation and tissue injury in reproductive organs, while increasing antimicrobial resistance (AMR), particularly in Neisseria gonorrhoeae and Mycoplasma genitalium, further compromises treatment efficacy. AMR arises through mechanisms including target-site mutations, reduced permeability, efflux pumps, enzymatic drug inactivation, and biofilm formation, potentially resulting in treatment failure and persistent infection. Repeated antibiotic exposure may also disrupt the genital tract microbiome, promoting pathogen persistence, inflammation, and reproductive dysfunction. This review summarizes current evidence on AMR patterns and resistance mechanisms in major genital tract pathogens, their potential association with reproductive tract damage and infertility, and current diagnostic and therapeutic challenges. Emerging strategies for resistance-guided therapy, rational antimicrobial use, and microbiome preservation are also discussed.

کلیدواژه ها:

Antibiotic resistance ، Genital tract infections ، Infertility ، Mycoplasma genitalium ، Neisseria gonorrhoeae