Time has come to include Human Papillomavirus (HPV) testing in sperm donor banks

C E Depuydt, Ggg Donders, L Verstraete, D Vanden Broeck, Jfa Beert, G Salembier, E Bosmans, N DhontT, I Van Der Auwera, K Vandenborne, W Ombelet, C E Depuydt, Ggg Donders, L Verstraete, D Vanden Broeck, Jfa Beert, G Salembier, E Bosmans, N DhontT, I Van Der Auwera, K Vandenborne, W Ombelet

Abstract

HPV is well known as a potential cause of cervical cancer. Less well known is its link to temporal subfertility that is caused by binding of infectious virions to the spermatozoa's head which induces sperm-DNA damage and causes a reduction in clinical pregnancy rates in women receiving HPV positive semen. This impact on the global fertility burden remains greatly underestimated and underexplored. This risk of reduced fertility due to infectious HPV in sperm is especially important when donor sperm insemination is considered, since testing for the presence of HPV virions before use seems warranted. We tested 514 donor sperm samples from 3 different sperm banks for 18 different HPV types. Overall 3.9% (20/514) of tested donor sperm was positive for HPV, with different prevalence among the 3 different sperm banks (3.6% bank A, 3.1% bank B and 16.7% bank C). Also the HPV virion per spermatozoon ratio in donor samples was similar across the different sperm banks (95% CI 0,01 to 1,07 HPV virions/spermatozoon). When HPV positive donor sperm was used, no clinical pregnancies resulted, whereas when HPV negative donor sperm was used the clinical pregnancy rate was 14.6%. From both a cost/benefit and a safety point of view we recommend that donor sperm should always be tested for HPV before using it for insemination.

Keywords: donor sperm; infectious; infertility; intrauterine insemination; semen; spermatozoa; transient virion producing.

Figures

Figure 1
Figure 1
HPV virion per spermatozoon ratio in HPV positive donor sperm according to sperm bank. The dashed line represents the 0,66 HPV virions per spermatozoon cut-off above which no clinical pregnancies could be achieved when HPV positive sperm was used for IUI (ref Depuydt Fertil Steril). Following HPV types were quantified with real time qPCR: HPV 6,11,16,18,31,33,35,39,45,51,52,53,56,58,59,67 and 68. When different HPV types were present in donor sperm, the number of copies per ml of sperm for each individual HPV type was added and divided by the number of spermatozoa per ml.

References

    1. Basky G. Potential sperm donors should be tested for HPV. CMAJ. 2000;163:324.
    1. Boeri L, Capogrosso P, Ventimiglia E, et al. High-risk human papillomavirus in semen is associated with poor sperm progressive motility and a high sperm DNA fragmentation index in infertile men. Hum Reprod. 2019;34:209–217.
    1. Brossfield JE, Chan PJ, Patton WC, et al. Tenacity of exogenous human papillomavirus DNA in sperm washing. J Assist Reprod Genet. 1999;16:325–328.
    1. Calhaz-Jorge C, de Geyter C, Kupka MS, et al. Assisted reproductive technology in Europe, 2012: results generated from European registers by ESHRE. Hum Reprod. 2016;31:1638–1652.
    1. Chan PJ, Su BC, Kalugdan T, et al. Human papillomavirus gene sequences in washed human sperm deoxyribonucleic acid. Fertil Steril. 1994;61:982–985.
    1. D’Hauwers K, Tjalma W, Punjabi U, et al. Human Papillomavirus and Related Diseases - From Bench to Bedside - A Clinical Perspective. 2012. Human Papillomavirus in Donor Semen in Belgium; pp. 305–18.
    1. Depuydt CE, Benoy IH, Bailleul EJ, et al. Improved endocervical sampling and HPV viral load detection by Cervex-Brush Combi. Cytopathology. 2006;17:374–381.
    1. Depuydt CE, Boulet GA, Horvath CA, et al. Comparison of MY09/11 consensus PCR and type-specific PCRs in the detection of oncogenic HPV types. J Cell Mol Med. 2007;11:881–891.
    1. Depuydt CE, Benoy IH, Beert JF. Clinical validation of a type-specific real-time quantitative human papillomavirus PCR against the performance of hybrid capture 2 for the purpose of cervical cancer screening. J Clin Microbiol. 2012a;50:4073–4077.
    1. Depuydt CE, Criel AM, Benoy IH, et al. Changes in type-specific human papillomavirus load predict progression to cervical cancer. J Cell Mol Med. 2012b;16:3096–3104.
    1. Depuydt CE, Jonckheere J, Berth M, et al. Serial type-specific human papillomavirus (HPV) load measurement allows differentiation between regressing cervical lesions and serial virion productive transient infections. Cancer Med. 2015;4:1294–1302.
    1. Depuydt CE, Beert J, Bosmans E, et al. Human Papillomavirus (HPV) virion induced cancer and subfertility, two sides of the same coin. FactsViewsVis Obgyn. 2016a;8:211–222.
    1. Depuydt CE, Thys S, Beert J, et al. Linear viral load increase of a single HPV-type in women with multiple HPV infections predicts progression to cervical cancer. Int J Cancer. 2016b;139:2021–2032.
    1. Depuydt CE, Donders GGG, Verstraete L, et al. Infectious human papillomavirus virions in semen reduce clinical pregnancy rates in women undergoing intrauterine insemination. Fertil Steril. 2019;111:1135–1144.
    1. Foresta C, Ferlin A, Bertoldo A, et al. Int J Androl. Human papilloma virus in the sperm cryobank: an emerging problem. 2011a;34:242–246.
    1. Foresta C, Patassini C, Bertoldo A, et al. Mechanism of human papillomavirus binding to human spermatozoa and fertilizing ability of infected spermatozoa. PLoS One. 2011b;6:e15036.
    1. Garolla A, Engl B, Pizzol D, et al. Spontaneous fertility and in vitro fertilization outcome: new evidence of human papillomavirus sperm infection. Fertil Steril. 2016;105:65–72.
    1. Gizzo S, Ferrari B, Noventa M, et al. Male and couple fertility impairment due to HPV-DNA sperm infection: update on molecular mechanism and clinical impact--systematic review. Biomed Res Int. 2014;2014:230263.
    1. Kaspersen MD, Bungum M, Fedder J, et al. No increased sperm DNA fragmentation index in semen containing human papillomavirus or herpesvirus. Andrology. 2013;1:361–364.
    1. Kaspersen MD, Larsen PB, Ingerslev HJ, et al. Identification of multiple HPV types on spermatozoa from human sperm donors. PLoS One. 2011;6:e18095.
    1. Micalessi IM, Boulet GA, Bogers JJ, et al. High-throughput detection, genotyping and quantification of the human papillomavirus using real-time PCR. Clin Chem Lab Med. 2012;50:655–661.
    1. Munoz N, Bosch FX, de Sangosé S, et al. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003;348:518–527.
    1. Olatunbosun O, Deneer H, Pierson R. Human papillomavirus DNA detection in sperm using polymerase chain reaction. Obstet Gynecol. 2001;97:357–360.
    1. Patterson NA, Smith JL, Ozbun MA. Human papillomavirus type 31b infection of human keratinocytes does not require heparan sulfate. J Virol. 2005;79:6838–6847.
    1. Schoonjans F, Zalata A, Depuydt CE, et al. MedCalc: a new computer program for medical statistics. Comput Methods Programs Biomed. 1995;48:257–262.
    1. Superior health councel No 9180. The role of HPV in fertility. Should male donor gametes be screened. . 2014.
    1. Thijssen A, Dhont N, Vandormael E, et al. Artificial insemination with donor sperm (AID): heterogeneity in sperm banking facilities in a single country (Belgium). Facts Views Vis Obgyn. 2014;6:57–67.
    1. Verhelst S, Poppe WA, Bogers JJ, et al. Serial measurement of type-specific human papillomavirus load enables classification of cervical intraepithelial neoplasia lesions according to occurring human papillomavirus-induced pathway. Eur J Cancer Prev. 2016;26:156–164.
    1. Xiong YQ, Chen YX, Cheng MJ. The risk of human papillomavirus infection for male fertility abnormality: a meta-analysis. Asian J Androl. 2018;20:493–497.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj