Semen alterations in HIV-1 infected men

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Abstract
BACKGROUND: Couples in whom the man is infected by human immunodeficiency virus (HIV) increasingly request assisted reproductive technology (ART) to allow safe procreation. Semen quality is critical in such situations. METHODS: Semen characteristics were evaluated in 189 HIV-infected men requesting ART. At the time of semen analysis all men were healthy and 177 were receiving anti-retroviral therapy. Comparisons were made with HIV-seronegative men, partners of women requiring IVF because of tubal infertility, after matching for age and sexual abstinence delay. RESULTS: The most significant semen alterations found in the HIV-infected men were reduced percentages of rapidly progressive sperm [median (range), 10% (0–30%) compared with 15% (5–30%) in the controls, P < 0.001], and increased concentrations of non-spermatic cells [3×106/ml (0.2–16×106/ml) compared with 1.1×106/ml (0.1–14×106/ml) in the controls, P < 0.001]. HIV-infected men also showed lower ejaculate volumes [2.8 ml (0.6–9.3 ml) compared with 3.6 ml (1.1–11 ml), P < 0.05] and total sperm counts [262.5×106 (0–1003×106) compared with 310.5×106 (48.3–1679×106), P < 0.05]. CONCLUSIONS: Semen evaluation in a large population of HIV-infected men requesting ART evidenced several alterations. Some of these anomalies might be related to anti-retroviral treatments.

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