Negative Impact of Elevated DNA Fragmentation and Human Papillomavirus (HPV) Presence in Sperm on the Outcome of Intra-Uterine Insemination (IUI).
Negative Impact of Elevated DNA Fragmentation and Human Papillomavirus (HPV) Presence in Sperm on the Outcome of Intra-Uterine Insemination (IUI).
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DOI：
10.3390/jcm10040717
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发表时间：
2021-02-11
影响因子：
3.9
通讯作者：
Ombelet W
中科院分区：
文献类型：
--
作者：
Depuydt C;Donders G;Verstraete L;Beert J;Salembier G;Bosmans E;Dhont N;Kerkhofs C;Ombelet W
我们想要确定接受精子宫腔内人工授精 (IUI) 的女性临床妊娠的精子 DNA 碎片指数 (DFI) 临界值，并评估人乳头瘤病毒 (HPV) 感染对精子 DNA 损伤的影响及其对临床妊娠的影响。前瞻性非介入性多中心研究，对 161 名不孕夫妇在比利时佛兰德斯的医院生育中心进行了 209 个周期的 IUI。在用于 IUI 之前，使用类型特异性定量 PCR（HPV 6、11、16、18、31、33、35、39、45、51、52、53、56、58、59、66 和 68）测量精子中的 DFI 和 HPV DNA。以临床妊娠（CP）率作为结果来分析对生育结果的影响并计算DFI的临床临界值。通过接受者操作特征 (ROC) 曲线分析获得 26% 的 DFI 标准值。男性 DFI > 26% 的夫妇的 CP 显着低于 DFI 低于 26% 的夫妇（OR 0.0326；95% CI 0.0019 至 0.5400；p = 0.017）。在精子中，HPV 患病率为 14.8%/IUI 周期。与 HPV 阴性精子样本相比，含有 HPV 的精子样本的 DFI 显着更高（29.8% vs. 20.9%；p = 0.011）。当精子中存在 HPV 病毒体时，没有观察到临床妊娠。精液参数正常的样本中，超过五分之一（17/78；21.8%）的 DFI 升高或 HPV 呈阳性。精子 DFI 是接受该精子 IUI 的女性临床妊娠的有力预测指标。当DFI超过26%时，临床妊娠的可能性较小，应考虑体外受精技术。
We wanted to determine the sperm DNA fragmentation index (DFI) cutoff for clinical pregnancies in women receiving intra-uterine insemination (IUI) with this sperm and to assess the contribution of Human Papillomavirus (HPV) infection on sperm DNA damage and its impact on clinical pregnancies. Prospective non-interventional multi-center study with 161 infertile couples going through 209 cycles of IUI in hospital fertility centers in Flanders, Belgium. Measurement of DFI and HPV DNA with type specific quantitative PCRs (HPV 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68) in sperm before its use in IUI. Clinical pregnancy (CP) rate was used as the outcome to analyze the impact on fertility outcome and to calculated the clinical cutoff value for DFI. A DFI criterion value of 26% was obtained by receiver operating characteristic (ROC) curve analysis. Couples with a male DFI > 26% had significantly less CPs than couples with DFI below 26% (OR 0.0326; 95% CI 0.0019 to 0.5400; p = 0.017). In sperm, HPV prevalence was 14.8%/IUI cycle. Sperm samples containing HPV had a significantly higher DFI compared to HPV negative sperm samples (29.8% vs. 20.9%; p = 0.011). When HPV-virions were present in sperm, no clinical pregnancies were observed. More than 1 in 5 of samples with normal semen parameters (17/78; 21.8%) had an elevated DFI or was HPV positive. Sperm DFI is a robust predictor of clinical pregnancies in women receiving IUI with this sperm. When DFI exceeds 26%, clinical pregnancies are less likely and in vitro fertilization techniques should be considered.
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