Prevalence of human papillomavirus infection in the female partner of infertile couples undergoing IVF/ICSI-ET and subsequent reproductive outcomes

Abstract

Background Whether human papillomavirus (HPV) infection alters the efforts of assisted reproductive technology (ART) and whether it is associated with reproductive outcomes are controversial. In this study, we investigated the prevalence of human papillomavirus infection in the female partner of infertile couples and the reproductive outcomes after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). Methods We conducted a retrospective analysis on 8117 women from infertile couples who underwent IVF/ICSI treatment at Tangdu Hospital Reproductive Medical Center in 2020 and evaluated the prevalence of HPV infection in these women. These HPV-infected female patients undergoing ART were divided into high-risk HPV (hr-HPV) (n = 130) and low-risk HPV (lr-HPV) groups (n = 94), and non-infected women patients formed the negative group (n = 126). All patients underwent a fresh-cycle embryo transfer or a frozen-embryo cycle transfer after a controlled ovarian hyperstimulation cycle. We analyzed subsequent embryonic development and reproductive outcomes. Results Of the 8117 cases, 747 were infected with HPV (9.2%): 529 showed hr-HPV infection (70.82%; principally genotypes 16, 52, 53, 58, and 59); 175 exhibited lr-HPV infection (23.43%; primarily genotypes 6, 43, 44, 55, 61, and 81); and 43 cases were co-infected with hr-HPV and lr-HPV (5.76%). Except for the Day-3 good-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 a reduced 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 (sm-HPV), although we likewise observed no differences in ovum maturation, fertilization, or implantation rates (p > 0.05) between the sm-HPV group and the negative group, we discerned diminutions in the Day-3 good-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); and an augmented miscarriage rate (11.11% vs. 4.76%, p = 0.003), respectively. Logistic regression analyses indicated that sm-HPV 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). Conclusions High-risk HPV infections are predominant in the female partners of infertile couples. HPV infection in these women was associated with decreased miscarriage rate, and single-male-factor infertility influenced reproductive outcomes in couples undergoing IVF/ICSI treatment—both potentially due to HPV infection in the couple.