Department of Obstetrics and Gynecology, Galilee Medical Center, Faculty of Medicine, Bar Ilan University, Nahariya, Israel.
Division of Reproductive Endocrinology - IVF, Department of Obstetrics and Gynecology, Carmel Medical Center, Bruce & Ruth Rappaport Faculty of Medicine, Haifa, Israel.
Fertil Steril. 2020 May;113(5):955-969.e4. doi: 10.1016/j.fertnstert.2020.01.010.
To analyze the effect of human papilloma virus (HPV) sperm infection on sperm parameters and in vitro fertilization (IVF) outcomes.
Systematic review and meta-analysis.
Not applicable.
Men with HPV sperm infection and couples undergoing IVF.
Searches were conducted in the following databases: Medline(R), PubMed, Embase, Web of Science, Scopos, and the Cochrane Library. We included studies examining sperm parameters and IVF results in patients with and without HPV sperm infection.
Sperm analysis (concertation, count, volume, motility, morphology), according to the World Health Organization manual, pregnancy rate (PR), and miscarriage rate (MR).
Sixteen studies were included in this meta-analysis. The presence of HPV had a significant association with impaired sperm parameters in terms of concentration (mean difference [MD] -4.48, 95% confidence interval [CI] - 6.12 to -2.83), motility (MD -11.71, 95% CI - 16.15 to -7.26), and morphology (MD -2.44, 95% CI - 4.08 to -0.79. A review of the literature regarding ART outcomes showed an association between HPV infection and decreased PR, and an even stronger association between HPV infection and increased MR.
Our meta-analysis shows a negative effect of HPV on sperm concentration, motility, and morphology. Further subgroup and categorical analysis confirmed the clinical significance of impaired sperm motility in HPV-infected sperm, although the sperm count and morphology must be carefully analyzed. The studies reviewed reported lower PR and increased MR in couples with HPV-infected sperm. As most studies had a moderate risk of bias, these observations warrant further large, well-designed studies before introducing clinical management recommendations.
CRD42019127419.
分析人乳头瘤病毒（HPV）精子感染对精子参数和体外受精（IVF）结局的影响。
系统评价和荟萃分析。
不适用。
HPV 精子感染的男性和接受 IVF 的夫妇。
在以下数据库中进行了检索：Medline（R）、PubMed、Embase、Web of Science、Scopos 和 Cochrane 图书馆。我们纳入了研究 HPV 精子感染患者和非 HPV 精子感染患者精子参数和 IVF 结果的研究。
根据世界卫生组织手册评估精子分析（浓度、计数、体积、活力、形态）、妊娠率（PR）和流产率（MR）。
本荟萃分析纳入了 16 项研究。HPV 存在与精子参数受损显著相关，表现在浓度（平均差 [MD] -4.48，95%置信区间 [CI] -6.12 至 -2.83）、活力（MD -11.71，95% CI -16.15 至 -7.26）和形态（MD -2.44，95% CI -4.08 至 -0.79）。对 ART 结局相关文献的回顾表明，HPV 感染与 PR 降低相关，HPV 感染与 MR 增加的相关性甚至更强。
我们的荟萃分析表明 HPV 对精子浓度、活力和形态有负面影响。进一步的亚组和分类分析证实，HPV 感染精子活力受损具有临床意义，尽管精子计数和形态必须仔细分析。综述的研究报告 HPV 感染精子的夫妇 PR 降低和 MR 增加。由于大多数研究存在中度偏倚风险，这些观察结果需要进一步进行大型、精心设计的研究，然后才能提出临床管理建议。
PROSPERO 注册号：CRD42019127419。
