Introduction. Human papillomavirus (HPV) is often found in the sperm of sexually active men and is associated with a violation of sperm parameters, which negatively affects sperm motility and plays a possible role in male infertility.
Aim. The purposes of this study were to assess the prevalence and localization of HPV in the sperm of men from infertile couples undergoing treatment at a reproductive health center, as well as to study reproductive outcomes in case of natural pregnancies and pregnancies with assisted reproductive technologies (ART) help in couples with or without HPV in the semen.
Methods. In the period from 2013 to 2014, 226 infertile couples aged 25 to 40 years with normal or altered ejaculate parameters in men were included in the study. The ejaculate was examined by fluorescence in situ hybridization for the presence of HPV (FISH – method), antisperm antibodies were determined by the MAP test to detect IgG and IgA (FertiPro N.V., Sint-Martens-Latem, Belgium). After a diagnostic period of 6 months, women underwent intrauterine insemination (IV) or intracytoplasmic sperm injection (ICSI). The therapeutic women preparation for the ART was described. Spontaneous or assisted pregnancies, live births and miscarriages were recorded during the entire period of pregnancy.
Results. In 54 (23.9%) men HPV was detected in the semen: the virus was detected directly in the spermatozoa themselves, in cells of the desquamated epithelium, or in both groups of cells. During the observation period, spontaneous pregnancies in uninfected couples were observed. VI and ICSI were performed in 60 and 98 uninfected and 21 of 33 infected couples with 38.4% and 14.2% cumulative pregnancy rates, respectively. During the follow-up period a higher incidence of miscarriages in infected couples was shown (62.5% versus 16.7%, p <0.5). In the ejaculate samples from the HPV-infected couples who have given birth to healthy babies, the virus was detected in the desquamated cells, not in the spermatozoa.
Conclusion. A decrease in the frequency of natural and assisted pregnancies and an increase in the number of miscarriages was associated with the presence of HPV infection at the semen. Although the exact mechanism of the infection effect in the ejaculate on fertility remains unclear, this aspect is the subject of future researches. If confirmed, these results should fundamentally change the approach to diagnosis and treatment of infertile couples.