The role of electron microscopy of ejaculate in the diagnosis of infertility associated with human papillomavirus infection

Introduction. The problem of male infertility is multifactorial. However, in recent years, the question of the involvement of viruses, in particular human papillomaviruses (HPV), in the development of this condition has been actively discussed.

Purpose of the study. To study the role of ejaculate electron microscopy in the diagnosis of infertility associated with human papillomavirus infection.

Materials and methods: The analysis of the results of electron microscopic examination of the ejaculate in 51 patients aged 22 to 40 years (mean age 32.3 ± 6.4) with a diagnosis of infertility and pathospermia, combined with human papillomavirus infection (PVI), but with the absence of other risk factors, was carried out.

Results: Various variants of pathozoospermia were found in the ejaculate: asthenozoospermia (35.3%), asthenoteratazoospermia (31.4%), oligoasthenoteratazoospermia (19.6%), oligoasthenozoospermia (13.7%). Among the studied HPV types of high oncogenic risk prevailed (16, 18). More often (88.2%), HPV was registered as part of associations with dominance of types 16 and/or 18 and 33, as well as types 18 and 33. In electron microscopy, in 80.3% of cases, HPV was fixed on spermatozoa with localization on the acrosome (76.4%) and in the sperm plasma (52.9%).

Conclusions: PVI, regardless of the type of HPV and the localization of virions on spermatozoa, significantly impairs the progressive motility and morphology of spermatozoa. The electron microscopy method allows not only to detect HPV in the ejaculate, but also to clarify its localization on the spermatozoon and determine those negative changes in the spermatozoon that are caused by the virus.