Cytomegalovirus (CMV) infection—related to male and/or female infertility factors?
Received 17 July 2007; received in revised form 11 November 2007; accepted 11 November 2007. published online 13 February 2008.
Objective
To screen for cytomegalovirus (CMV) infection in male and female partners of subfertile couples and to analyze a potential relationship with clinically relevant parameters of male and female factor fertility.
Design
Prospective study.
Setting
Outpatient infertility clinic of a university-based hospital.
Patient(s)
Randomly selected male and female partners of asymptomatic subfertile couples.
Intervention(s)
None.
Main Outcome Measure(s)
Screening for CMV in the semen of the male partner (using nested polymerase chain reaction) and, at the same time, in the endocervical material of the female partner; same-day CMV serology (anti-CMV IgG and IgM class antibodies [Ab]); medical history and clinical examination; evaluation of semen quality, including sperm functional capacity and detection of antisperm Ab (ASA) and seminal white blood cells (WBC) in aliquots of the same ejaculates; bacterial screening of both partners; and detailed examination of the cervical factor and other variables of female subfertility.
Result(s)
The presence of CMV in semen was not significantly related to semen quality including sperm functional capacity, local antisperm Ab, or seminal WBC. CMV in endocervical material was not associated with a reduced quality of the cervical mucus or with other female infertility factors. CMV in semen was not associated with the presence of CMV in the endocervical material of the female partners. CMV infection was not significantly associated with other microorganisms of the lower genital tract. CMV serology (IgG and/or IgM Ab) did not sufficiently reflect CMV presence in semen or the cervix.
Conclusion(s)
CMV presence in the genital tract of subfertile patients is considerable, but findings do not suggest that sexual transmission is a frequent route of infection or that CMV infection is a significant cause of infertility.
aDepartment of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Heidelberg, Germany
bDepartment of Tumour Virology, German Cancer Research Center, Heidelberg, Germany
Reprint requests: Waltraud Eggert-Kruse M.D., Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Germany, Voßstraße 9, 69115 Heidelberg, 06221-567910 (FAX: 06221-56-5260).
Presented in part at the 21st Annual Meeting of the European Society of Human Reproduction and Embryology, which was held in Copenhagen, Denmark, on June 19–22, 2005.
ABSTRACT