Reproductive outcomes in couples affected by human papillomavirus infection undergoing in vitro fertilization procedures

Rosaria Schillaci, Antonino Perino, Ettore Cittadini, Pietro Alimondi

Risultato della ricerca: Otherpeer review

Abstract

Reproductive outcomes in couples affected by humanpapillomavirus infection undergoing in vitro fertilization proceduresG. Ruvolo1, L. Giovannelli2, R. Schillaci3, P. Alimondi3, A. Pane1, A. Perino3,E. Cittadini11Centro di Biologia della Riproduzione, Centro di Biologia della Riproduzione,Palermo, Italy2Dipartimento di Scienze per la Promozione della Salute, Dipartimento diScienze per la Promozione della Salute, Palermo, Italy3Dipartimento Materno Infantile University of Palermo, DipartimentoMaternoInfantile University of Palermo, Palermo, ItalyIntroduction: Genital human papillomavirus (HPV) infection is the most commonsexually transmitted viral infection worldwide, and has been associatedwith precancer and cancer of the male and female anogenital mucosa. Althoughit is well known that sexually transmitted infections are the primary cause ofinfertility few studies have investigated the effect of HPV infection on humanreproduction. It has been designed a prospective study to investigate the roleof HPV infection in infertile couples undergoing assisted reproductive technology(ART) cycles. The objectives of this study were to assess the prevalence ofHPV infection in infertile couples, and to evaluate the correlation between HPVinfection and ART outcome.Material and Methods: A total of 199 couples were enrolled from May 2008 toMay 2009. The mean age of women and men were 34.7 ± 5.01 and 38.0 ± 6.36years, respectively. Types of infertility were female (tubal occlusion, chronic anovulation,24.1%), male (severe oligoasthenoteratozoospermia, 58.6%), couple(6.8%), and idiopathic (10.5%). The exclusion criteria were: cases of azoospermia,couples with repeated implantation failures and cases of endometriosis.All women had undergone cervical cytologic screeningwithin the previous 12 months, with no cytologic abnormality reported. No patients tested were positivefor microbiological and viral infections. Patients were treated with standardovulation induction protocols and underwent cycles of ART. Cervical cellswere obtained with the combined use of an Ayre’s spatula and an endocervicalcytobrush before oocyte recovery by transvaginal ultrasound-guided follicularpuncture, and were placed in 20 mL of PreservCyt Solution (Cytyc Corp,). TotalDNAwas extractedwith the QIAampMiniKit (Qiagen,Germany).All investigations, both for IVF and ICSI procedures, were carried out onspermatozoa prepared with the swim-up technique. The association betweenpregnancy and miscarriage for demographic and clinical variables was assessedusing the Chi-square test or Fisher’s exact test, as appropriate. A P value %.05was considered statistically significant.Results: Out of the 199 couples, the male partner was HPV positive in 9.5% ofcouples (19/199), whereas the female partner had a positive HPV DNA test in17.5% of couples (35/199). Both partners were HPV positive in 4.5% (9/199)of couples.Statistical analysis showed no differences in the rate of pregnancy in termsof HPV status. When considering the HPV infection of couples, the PR was33.3% and 31.6%, respectively, in HPV negative and HPV positive men, and31.1% and 42.9%, respectively, in HPV negative and HPV positive women.Conversely, miscarriage rates showed statistically significant differences. Coupleswho underwent ART cycles experienced an increased risk of pregnancyloss when HPV DNA testing was positive in the male partner, compared withnon infected patients (66.7%–15%, P < 0.01. It is worth noting that all pregnanciesinHPV-positive couples resulted in miscarriage, whereas there was a15.9% overall miscarriage rate in HPV-n
Lingua originaleEnglish
Pagine32-34
Numero di pagine3
Stato di pubblicazionePublished - 2011

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