Semen abnormalities in patients with human papillomavirusassociated infertility detected by electron transmission microscopy

Introduction. Recent research have suggested a link between human papillomavirus (HPV) and declining male fertility.
Objective. To study the pathomorphological changes in ejaculate of patients with human papillomavirus-associated infertility using electron microscopy
Materials & methods. We analysed the results of transmission electron microscopy of ejaculate samples from 51 patients aged 22 to 40 years (mean age 32.3 ± 6.4) diagnosed with infertility and abnormal seminal parameters combined with HPV but without other risk factors. 
Results. Asthenozoospermia (35.3%) and asthenoteratozoospermia (31.4%) were more frequently detected among the various variants of abnormal semen parameters, while the proportion of oligoasthenoteratazoospermia and oligoasthenozoospermia was 19.6% and 13.7%, respectively. In all patients, PCR in the ejaculate revealed different HPV types; 17 (85.0%) of the 20 identified viruses belonged to high-risk HPV. HPV types 18 (33.3%), 16 (31.3%) 31 (27.4%) and 33 (21.5%) were predominant. Electron microscopy revealed HPV adherence on sperm with localisation on the acrosome (76.4%) and in the sperm plasma (52.9%) in 80.3% of cases.
Conclusions. Electron microscopy of the ejaculate of HPV-associated infertile patients revealed virus capsids were detected both on the sperm and in the sperm plasma. In addition, various sperm pathology was detected in 100% of cases, which was characterised by dysfunction of the acrosome, axoneme and nucleus. Among the acrosome pathologies, the most frequently observed were impaired integrity of the postacrosomal plate and enlargement of the subacrosomal space.

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