High prevalence of human papillomavirus at different steps of assisted reproductive procedures.

INTRODUCTION

Human papillomavirus (HPV) is the most common sexually transmitted agent. Its role on infertility and procreation outcomes is debated. Nevertheless, no recommendation exists on HPV-related risk management during Assisted Reproductive Technology (ART) procedures. The goal of this study was to evaluate the prevalence of HPV at different steps of ART and to investigate its role on infertility or pregnancy outcomes.

METHODS

a total of 914 consenting couples undergoing ART treatment were enrolled in a longitudinal prospective study across two French centers. The ART procedures included intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection. Sperm fractions, cervicovaginal fluids, and-when available-follicular fluids, embryo culture media, and newborn throat samples were tested for HPV DNA using a SPF10 real-time PCR assay combined with the LiPA assay (Fujirebio).

RESULTS

the prevalence of HPV DNA was 14.8% in semen and 16% in cervicovaginal samples. Sperm mobility was significantly decreased in HPV DNA positive semen (P = 0.04). No correlation was found between HPV detection and procreation success. A total of 501 pregnancies occurred leading to 457 childbirths. Among HPV positive women, 26.5% of follicular fluids and 9.1% of embryos culture medium also tested positive for HPV DNA, without HPV transmission to newborn in the 4 resulting pregnancies. Four out of 253 newborns tested positive for HPV at the throat level.

CONCLUSION

Our study suggests that HPV has very little or no effect on male fertility, pregnancy, or birth outcomes, even though the virus was detected at different steps of ART procedures. However, good practices for handling gametes must be strictly followed to avoid viral spreading. Generalizing the use of HPV vaccine is the best way to prevent any risks during fertility treatments.