Cytomegalovirus (CMV) infection—related to male and/or female infertility factors?

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.

Key Words: Cytomegalovirus (CMV), infertility, semen quality, sperm function, antisperm antibodies (ASA), sexually transmitted diseases (STD), cervical mucus (CM), cervical factor, sperm-mucus interaction