Intra Uterine Insemination in Two Couples with HPV Detection by Hyaluronidase-Based Swim-up Washing: Cases Report

Abstract

Human papillomavirus (HPV) infection is the most common sexually transmitted disease worldwide and is associated with negative reproductive outcomes because of which it is recommended to postpone medically assisted reproduction (MAR). This raises major concerns for elder infertile couples. We showed that a hyaluronidase-based sperm washing (IALu) procedure blunted the HPV viral load in semen. Here, were report two cases of couples with long-term idiopathic infertility, ascribed to persistent semen HPV detection, finding a beneficial outcome from the use of IALu protocol applied to intra-uterine insemination (IUI). Case 1: A Caucasian couple (female aged 32, male aged 35), complained of having been attempting pregnancy for 4 years. HPV-DNA (genotypes 51 and 54) was detected on sperms. After a first unsuccessful IUI cycle attempt, using standard swim-up selection of spermatozoa, a second IUI cycle using the IALu procedure was associated with a pregnancy and a successful trimester of gestation. Case 2: A Caucasian couple (female aged 43, male aged 52) complained of having been attempting pregnancy for 3 years and showed the detection of HPV-DNA (genotype 66) on sperms. After a first unsuccessful standard IUI cycle attempt, two further IUI cycles using IALu procedure were pursued. The last cycle was associated with a pregnancy and a successful trimester of gestation. Although preliminary, the IALu procedure is a promising approach for straightforward fertility treatments in cases of recurrent HPV-DNA semen detection, avoiding critical latencies.