The effect of human immunodeficiency virus on sperm parameters and the outcome of intrauterine insemination following sperm washing

Authors: James D.M. Nicopoullos; Paula A. Almeida; Jonathan W.A. Ramsay; Carole Gilling-Smith

Source: Human Reproduction, Volume 19, Number 10, October 2004 , pp. 2289-2297(9)

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Abstract:

BACKGROUND: This is the first study to assess the outcome of sperm washing and intrauterine insemination (IUI) cycles in human immunodeficiency virus-positive (HIV⁺) men to determine any predictors of success, as well as evaluating the effect of HIV on sperm parameters. METHODS: Semen characteristics were evaluated in 106 HIV⁺ men and a control group of 234 HIV^- men, and the effect of markers of HIV disease assessed. Age, stimulation regime, sperm parameters, markers of HIV disease and the use of anti-retrovirals were assessed as predictors of the outcome of sperm washing/IUI cycles in the HIV⁺ men. RESULTS: Ejaculate volume, sperm concentration, total count, progressive motility and normal morphology were all significantly higher in the control group compared to the HIV⁺ men (P<0.05). A significant positive correlation was observed between CD4 count and sperm concentration, total count, motility, progressive motility type ‘a’+‘b’ and post-preparation concentration and a significant negative correlation with normal sperm morphology of both raw and post-preparation samples. No correlation was observed between viral load (VL), years since diagnosis, use of anti-retrovirals or duration of use and any sperm parameter. The only factors that significantly improved IUI outcome were a VL <1000 copies/ml and the use of anti-retrovirals. CONCLUSIONS: These data demonstrate that sperm parameters are significantly impaired by the presence of HIV infection and in particular correlate with CD4 count. Undetectable VL and the use of anti-retrovirals improve the outcome of IUI/sperm washing in HIV⁺ men.

Keywords: HIV; intrauterine insemination; predictors of outcome; sperm washing

Document Type: Research article

DOI: http://dx.doi.org/10.1093/humrep/deh426

Affiliations: 1: Assisted Conception Unit, Chelsea & Westminster Hospital, London SW10 9NH and

Publication date: 2004-10-01

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Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.

The effect of human immunodeficiency virus on sperm parameters and the outcome of intrauterine insemination following sperm washing

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