Christophe Eric Depuydt1, Gilbert Ghislain Gerard Donders2, Ludo Verstraete3, Davy Vanden Broeck4, Johan Frans Andre Beert5, Geert Salembier6, Eugene Bosmans3, Willem Ombelet7. 1. Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, Antwerp, Belgium; Intermediate Structure for Human Body Material, AML, Sonic Healthcare, Antwerp, Belgium. Electronic address: christophe.depuydt@aml-lab.be. 2. Femicare, Clinical Research for Women, Regional Hospital Heilig Hart, Tienen, Belgium; Department of Obstetrics and Gynecology, Regional Hospital Heilig Hart, Tienen, Belgium; University Hospital Antwerpen, Antwerp, Belgium. 3. Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, Antwerp, Belgium; Intermediate Structure for Human Body Material, AML, Sonic Healthcare, Antwerp, Belgium. 4. Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium; National Reference Centre for HPV, Brussels, Belgium; Department of Obstetrics and Gynecology, International Centre for Reproductive Health, Ghent University, Ghent, Belgium. 5. Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, Antwerp, Belgium; Intermediate Structure for Human Body Material, AML, Sonic Healthcare, Antwerp, Belgium; Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium. 6. Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium. 7. Genk Institute for Fertility Technology, ZOL Hospitals, Genk, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
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.
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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