Infectious human papillomavirus virions in semen reduce clinical pregnancy rates in women undergoing intrauterine insemination

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Authors:

Christophe Eric Depuydt, M.Sc., Ph.D., Gilbert Ghislain Gerard Donders, M.D., Ph.D., Ludo Verstraete, M.D., Davy Vanden Broeck, Ph.D., Johan Frans Andre Beert, M.D., Geert Salembier, Pharm.D., Eugene Bosmans, Pharm.D., Willem Ombelet, M.D., Ph.D.

Abstract:

Objective

To study the influence of human papillomavirus (HPV) virions present in different sperm fractions of male partners of women undergoing IUI on fertility outcome.

Design

Prospective noninterventional multicenter study.

Setting

Inpatient hospital fertility centers.

Patient(s)

Seven hundred thirty-two infertile couples undergoing 1,753 IUI cycles with capacitated sperm.

Intervention(s)

None.

Main Outcome Measure(s)

Biochemical and clinical pregnancy rate in IUI cycles with HPV-positive or HPV-negative semen.

Result(s)

Five hundred seventy-three infertile couples undergoing 1,362 IUI cycles were enrolled. Work-up of the 1,362 sperm samples that were used for IUI generated 3,444 separate sperm fractions. Each of the sperm fractions was tested with quantitative polymerase chain reaction for 18 different HPV types (6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 67, and 68). HPV prevalence in sperm was 12.5%/IUI cycle. When infectious HPV virions were detected in sperm, a significant decrease in clinical pregnancies was observed when compared with HPV-negative cycles (2.9% vs. 11.1 %/cycle). Above a ratio of 0.66 HPV virions/spermatozoon no pregnancies occurred (sensitivity 100%, specificity 32.5%).

Conclusion(s)

Women inseminated with HPV-positive sperm had 4 times fewer clinical pregnancies compared with women who had HPV-negative partners. Detection of HPV virions in sperm is associated with a negative IUI outcome and should be part of routine examination and counseling of infertile couples.

European Clinical Trials Database Number

2017-004791–56.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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