男性病毒感染与不孕不育的关联:系统评价与荟萃分析。

The Association Between Male Viral Infections and Infertility: A Systematic Review and Meta-Analysis.

机构信息

Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China.

Department of Reproductive Gynecology, The First People's Hospital of Yunnan Province, Kunming, China.

出版信息

Rev Med Virol. 2024 Nov;34(6):e70002. doi: 10.1002/rmv.70002.

Abstract

Infertility affects approximately one-sixth of couples worldwide, with male factors contributing to half of all cases. However, infections, particularly those of reproductive tract, are increasingly recognized as important contributors to male infertility. Therefore, in this meta-analysis, we focused on the impact of various viral infections on male infertility. We searched PubMed, Embase, Web of Science and Cochrane Library on 20 October 2023. And included 135 studies involving 30,298 men of reproductive age. We found that the human papilloma virus (HPV)-infected group had a significantly higher DNA fragmentation index (DFI) than the non-infected group, with a mean difference (MD) of 5.64 (95% CI: 3.74-7.54). Conversely, the HPV-infected group had significantly lower sperm count, concentration, viability and normal morphology. Other viruses that affect semen quality include hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). HBV significantly decreased fertilization rate, with an odds ratio (OR) of 0.86 (95% CI: 0.76-0.99). HPV associated with lower clinical pregnancy rate (OR: 0.31 [95% CI: 0.16-0.62]) and higher miscarriage rate (OR: 5.28 [95% CI: 2.02-13.78]). Additionally, the fertility treatment group had a significantly higher rate of HPV infection (OR: 1.85 [95% CI: 1.10-3.12]) and adeno-associated virus (AAV) infection (OR: 8.49 [95% CI: 2.66-27.10]) than the fertility group. Conclusively, most viral infections affect semen quality, while HBV and HPV may affect assisted reproductive technology (ART) outcomes. HPV and AAV are risk factors for infertility.

摘要

不育症影响全球约六分之一的夫妇,其中一半的病例与男性因素有关。然而,感染,尤其是生殖道感染,越来越被认为是男性不育的重要原因。因此,在这项荟萃分析中,我们重点关注了各种病毒感染对男性不育的影响。我们于 2023 年 10 月 20 日检索了 PubMed、Embase、Web of Science 和 Cochrane Library,并纳入了 135 项研究,共涉及 30298 名育龄男性。我们发现,人乳头瘤病毒(HPV)感染组的 DNA 碎片化指数(DFI)明显高于未感染组,平均差异(MD)为 5.64(95%置信区间:3.74-7.54)。相反,HPV 感染组的精子计数、浓度、活力和正常形态明显较低。其他影响精液质量的病毒包括乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、人类免疫缺陷病毒(HIV)和严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)。HBV 显著降低受精率,优势比(OR)为 0.86(95%置信区间:0.76-0.99)。HPV 与较低的临床妊娠率相关(OR:0.31 [95%置信区间:0.16-0.62])和较高的流产率相关(OR:5.28 [95%置信区间:2.02-13.78])。此外,与生育组相比,生育治疗组 HPV 感染(OR:1.85 [95%置信区间:1.10-3.12])和腺相关病毒(AAV)感染(OR:8.49 [95%置信区间:2.66-27.10])的发生率明显更高。综上所述,大多数病毒感染会影响精液质量,而 HBV 和 HPV 可能会影响辅助生殖技术(ART)的结果。HPV 和 AAV 是不育的危险因素。

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