Morphological abnormalities in oocytes in patients with HIV infection receiving antiretroviral therapy


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Abstract

Aim: To study the prevalence of oocyte dysmorphisms in HIV-infected women receiving antiretroviral therapy (ART). Materials and methods: The retrospective study included 210 married couples who underwent IVF. The main group included 113 HIV-infected patients, and the control group included 97 women without HIV infection, who underwent 163 and 123 ovarian stimulation cycles, respectively. Morphological assessment of 2321 mature MII oocytes was performed, of them 1228 oocytes were obtained in the main group and 1093 in the control group.. Results: The median age of patients with HIV infection was 34 (31;37) years; duration of the diseases and Art WAS 8 (5;11) and 3.6 (2;6) years, respectively. 65 of 113 women (57.5%; 95% CI: 47.8- 66.4) had subclinical stage 3 of the disease, 43 women (38.1%; 95% CI: 29.2-47.8) had stage 4A, 2 women (1.8%; 95% CI: 0-4.4) had stage 4B, and 3 women (2.7%; 95% CI: 0-6.2) had stage 3C of HIV infection (Russian HIV classification). The average CD4+ lymphocytes count was 582 (432;807) cells/pl, and immunoregulatory index (IRI) was 0.87. All patients received ART and had had an undetectable viral load in the blood beforee IVF treatment. The prevalence of various types of oocyte dysmorphisms in HIV-infected women was significantly higher versus the women in the control group and was 29.5% (362/1228) and 14.1% (154/1093), respectively (р<0.001, RR 2.0; 95% CI: 1.765-2.480). Among ocyte cytoplasmic abnormalities in both groups, centrally located cytoplasmic granulation (CICG) prevailed. Detection rate of this type of dysmorphisms was 17.3% (213/1229) in the main group, and 10% (109/1093) in the control group. The difference was statistically significant (р<0.001; RR 2.26; 95% CI: 1.8-2.7). The prevalence of extracytoplasmic abnormalities of oocytes, as well as combination of their types in HIV-infected patients was comparable with HIV-seronegative control. Conclusion: The higher prevalence of oocyte dysmorphisms in HIV-infected patients who received ART versus healthy women, indicates deterioration of the morphological features of oocytes in this group of patients.

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About the authors

Elena V. Mityurina

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: mity-elena@yandex.ru
PhD, Senior Researcher, F. Paulsen Research and Clinical Department for Assisted Reproductive Technologies

Svetlana S. Perminova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: perisvet@list.ru
Dr. Med. Sci., Leading Researcher, F. Paulsen Research and Clinical Department for Assisted Reproductive Technologies

Alexey V. Kravchenko

Central Research Institute of Epidemiology of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)

Email: alexey-kravtchenko@yandex.ru
Dr. Med. Sci., Professor, Leading Researcher

Nadezhda V. Kozyrina

Central Research Institute of Epidemiology of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)

Email: nad-kozyrina@yandex.ru
PhD, Researcher

Maria A. Veyukova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: veymary@gmail.com
MD, PhD, Leading Embriologist of Reproductology Department

Alexandra A. Gaponenko

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: sasha.gap@mail.ru
post-graduate student, F. Paulsen Research and Clinical Department for Assisted Reproductive Technologies

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