Wei Sanhua, Wang Kaili, Cheng Fang, Chang Zhenhua, Ren Xiaoyan, Liu Zheng, Liu Mengxin, Yang Tao, Ma Xuhui, Xie Xiaojuan, Wang Xiaohong
Reproductive Medicine Center, Department of Obstetrics and Gynaecology, Tang Du Hospital, The Air Force Military Medical University, Xi'an 710038, China.
J Clin Med. 2022 Dec 2;11(23):7185. doi: 10.3390/jcm11237185.
We investigated the prevalence of human papillomavirus (HPV) infection in the female partner of infertile couples and the reproductive outcomes after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). We conducted a retrospective analysis on 8117 women from infertile couples who underwent IVF/ICSI treatment and evaluated the prevalence of HPV infection in these women. The prevalence of HPV infection in the female partner of infertile couples was 9.2% (747/8117). These HPV-infected female patients undergoing ART were divided into high-risk HPV (hrHPV) (n = 130) and low-risk HPV (lrHPV) groups (n = 94), and non-infected women patients formed the negative group (n = 126). Of the 747 cases infected with HPV, 529 showed hrHPV infection (70.82%; primarily genotypes 16, 52, 53, 58, and 59); 175 exhibited lrHPV infection (23.43%; primarily genotypes 6, 43, 44, 55, 61, and 81); and 43 cases were co-infected with hrHPV and lrHPV (5.76%). Except for the Day-3 high-quality embryo rate, there were no differences in ovum maturation, fertilization, implantation, clinical pregnancy, live birth, or miscarriage rates between women infected with HPV and non-infected women (p > 0.05); however, we noted an increased miscarriage rate after logistic regression analyses (OR, 0.16; 95% CI, 0.03−0.84; p = 0.041). For single-male-factor-induced infertility in couples (smHPV), although we likewise observed no differences in ovum maturation, fertilization, or implantation rates (p > 0.05) between the smHPV group and the negative group, we discerned diminutions in the Day-3 high-quality embryo rate (46.01% vs. 70.04%, p = 0.013), clinical pregnancy rate (46.67% vs. 57.94%, p = 0.003), and live birth rate (33.33% vs. 46.83%, p = 0.027) as well as an augmented miscarriage rate (11.11% vs. 4.76%, p = 0.003), respectively. Logistic regression analyses indicated that smHPV was a risk factor for decreased clinical pregnancy rate (OR, 4.17; 95% CI, 2.31−7.53; p < 0.001) and live birth rate (OR, 1.83; 95% CI, 0.81−2.14; p = 0.045) and elevated miscarriage rate (OR, 6.83; 95% CI, 2.22−21.00; p = 0.001). HPV infection in women was associated with increased miscarriage rate, and single-male-factor infertility influenced reproductive outcomes in couples undergoing IVF/ICSI treatment. Both were potentially due to HPV infection in the couple.
我们调查了不育夫妇中女性伴侣的人乳头瘤病毒(HPV)感染率以及体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)后的生殖结局。我们对8117名接受IVF/ICSI治疗的不育夫妇中的女性进行了回顾性分析,并评估了这些女性中HPV感染的患病率。不育夫妇中女性伴侣的HPV感染率为9.2%(747/8117)。这些接受辅助生殖技术(ART)的HPV感染女性患者被分为高危型HPV(hrHPV)组(n = 130)和低危型HPV(lrHPV)组(n = 94),未感染的女性患者组成阴性组(n = 126)。在747例HPV感染病例中,529例表现为hrHPV感染(70.82%;主要基因型为16、52、53、58和59);175例表现为lrHPV感染(23.43%;主要基因型为6、43、44、55、61和81);43例为hrHPV和lrHPV合并感染(5.76%)。除了第3天优质胚胎率外,HPV感染女性与未感染女性在卵子成熟、受精、着床、临床妊娠、活产或流产率方面均无差异(p>0.05);然而,经逻辑回归分析后,我们注意到流产率有所增加(比值比[OR],0.16;95%置信区间[CI],0.03−0.84;p = 0.041)。对于夫妇中由单一男性因素导致的不育(smHPV),尽管我们同样观察到smHPV组与阴性组在卵子成熟、受精或着床率方面无差异(p>0.05),但我们发现第3天优质胚胎率降低(46.01%对70.04%,p = 0.013)、临床妊娠率降低(46.67%对57.94%,p = 0.003)和活产率降低(33.33%对46.83%,p = 0.027),以及流产率升高(11.11%对4.76%,p = 0.003)。逻辑回归分析表明,smHPV是临床妊娠率降低(OR,4.17;95%CI,2.31−7.53;p<0.001)和活产率降低(OR,1.83;95%CI,0.81−2.14;p = 0.045)以及流产率升高(OR,6.83;95%CI,2.22−21.00;p = 0.001)的危险因素。女性HPV感染与流产率增加有关,单一男性因素不育影响接受IVF/ICSI治疗夫妇的生殖结局。两者可能都归因于夫妇中的HPV感染。