Hum. Reprod. Advance Access originally published online on December 17, 2004
Human Reproduction 2005 20(4):1028-1034; doi:10.1093/humrep/deh699
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Semen characteristics in human immunodeficiency virus (HIV)- and hepatitis C (HCV)-seropositive males: predictors of the success of viral removal after sperm washing
1 IVI Valencia, 2 FIVI (Fundación IVI), 3 Departments of Paediatrics, Obstetrics and Gynaecology, Valencia University School of Medicine and 4 Department of Obstetrics and Gynaecology Hospital Dr Peset, Valencia, Spain
5 To whom correspondence should be addressed at: Instituto Valenciano de Infertilidad, Andrology Laboratory and Semen Bank, Plaza de la Policía Local 3, Valencia 46015, Spain. Email: nicolas.garrido{at}ivi.es
BACKGROUND: Human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-seropositive males can now father children safely, avoiding transmission risks to the mother and the children using sperm washing and nested PCR (nPCR) techniques. Nevertheless, we still lack enough data to determine the reasons why
10% of the performed sperm washes remain positive, thus forcing the repetition of the treatment. Semen quality in infected males is also essential to these procedures. We aimed to determine the predictive value of the semen parameters, sperm washing procedure and the infection status for the post-wash viral positivity, as well as the correlation between the semen and the disease features. METHODS: Semen characteristics were evaluated in 136 samples provided from 125 males. We also included a control group of 125 males matched by age and length of sexual abstinence. At the time of semen retrieval, 70 of them were infected with HIV (45 also with HCV, 64.3%), and 55 of them with HCV alone. nPCR for viral detection was performed in each sample. RESULTS: Thirteen out of 136 (9.5%) of the samples were positive for one or more viral detections (HIV RNA, HIV DNA and HCV RNA, when needed). From a total of 240 nPCR viral analyses, 16 were positive (6.6%). None of the seminal parameters were adequate to predict post-wash results, nor was a positive result dependent on the volumes used in the semen wash. A positive correlation was found between post-wash progressive motility and CD4 blood levels, as well as a negative correlation between progressive motility and time of evolution of the disease in HIV-infected males. CONCLUSIONS: Semen analysis, according to the World Health Organization criteria, of HIV- and HCV-affected patients showed no differences from that of non-infected males. Moreover, low CD4 blood levels, and a long evolution of the disease do not negatively affect sperm motility.
Key words: HIV and HCV/ICSI/nested PCR/semen wash/serodiscordant
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