Presentation Authors: Luca Boeri*, Paolo Capogrosso, Eugenio Ventimiglia, Walter Cazzaniga, Filippo Pederzoli, Francesco Chierigo, Edoardo Pozzi, Franco Gaboardi, Milan, Italy, Emanuele Montanari, Milano, Italy, Francesco Montorsi, Andrea Salonia, Milan, Italy
Introduction: Human papillomavirus (HPV) is commonly present in semen sample. However, whether the presence of HPV in semen is actually associated with impaired semen parameters and sperm DNA fragmentation (SDF) values has yet to be elucidated. We aimed to assess the impact of the presence of HPV in semen over the seminal parameters and SDF values in primary infertile men.
Methods: Complete data from 729 infertile men were analysed. Comorbidities were scored with the Charlson Comorbidity index (CCI). Serum hormones and sperm DNA fragmentation index (SDF; SDF â‰¥30% was defined as pathologic) were measured in every patient. Semen analysis was based on 2010 WHO reference criteria. Amplification by nested polymerase chain reaction (PCR) was used to detect HPV-DNA sequences in semen samples. Descriptive statistics and linear regression models tested the association between HPV presence and clinical and seminal characteristics in the whole cohort.
Results: The overall HPV positivity was 15.5% (113/729). Of all, 78/729 (10.7%) and 35/729 (4.8%) patients had high-risk (HR) HPV+ and low-risk (LR) HPV+, respectively. HPV16 was the most prevalent type (22.1%), followed by HPV43 (10.6%), HPV56 and HPV42 (both 8.8%). No differences were found in terms of clinical and hormonal characteristics between patients with or without seminal HPV. Sperm progressive motility was lower (16% vs. 22%; p=0.01) while SDF values were higher (35.9% vs. 28.3%; p=0.005) in HPV+ than in -HPV patients. HR HPV+ men had lower sperm progressive motility (12.5% vs. 22%; p=0.007) and higher SDF values (40.3% vs. 28.3%; p=0.003) than -HPV. Univariable linear regression analysis showed that HR HPV+ was associated with impaired sperm progressive motility (p=0.002) and SDF values (p=0.003). At multivariable analysis, age (beta -0.36), FSH levels (beta -0.51) and testicular volume (beta 0.66) were associated with impaired sperm progressive motility (all pâ‰¤0.04). Conversely BMI, CCI, smoking habits and HPV status were not. Only age (beta 0.4; p=0.02) and FSH (beta 1.38; p=0.01) were associated with SDF, after accounting for BMI, CCI, testicular volume, smoking habits and HPV status.
Conclusions: HPV seminal infection, in particular infections involving exclusively HR genotypes, was associated with impaired sperm progressive motility and SDF values. These findings outline the role of an accurate investigation of seminal HPV presence over the diagnostic work-up of primary infertile men.