Abstract
Objective The rate of infertility continues to be on the increase in the developing world. Similarly, the rates of blood-borne viral infections (BBVs) such as Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are also on this rise. In 2014, the World Health Organization (WHO) quoted prevalences of 1.5% (HIV), 15% (HBV) 1.3 - 8.4% (HCV) in the Ghanaian general population. It has been reported that BBVs can adversely affect male fertility, specifically sperm count and progressive motility. The aim of this study was to evaluate the prevalence of BBVs in people with infertility attending an IVF clinic and whether or not BBVs impacted on sperm parameters.Methods A retrospective cohort study at a private fertility center in Accra, Ghana. We had 229 recruited couples assayed for HBV, HCV and HIV. Sperm parameters of the male partners were also assessed. The analysis performed included student t-test and Fisher's exact test.Results We found prevalence rates of 1.7% (HIV), 7.9% (HBV) and 0.4% (HCV), which is similar to what has already been reported in the Ghanaian community. There was no significant difference between BBV positive and negative subjects for sperm count (13.6 million/ml vs. 17.7 million/ml, P = 0.0599), percentage of progressive motility (26% vs. 30%, P = 0.2129), percentage of normal forms (3% vs. 3%, P = 0.0617) and clinical pregnancy rates per embryo transfer (36.1% vs 34.9%, P = 0.5) between BBV positive and BBV negative subjects, respectively. Conclusion There is a similar prevalence of BBVs in sub-fertile couples and the general Ghanaian population. However, no detrimental effect has been reported for sperm parameters on grounds of BBV infectivity of the male partner.
Highlights
Worldwide more than 70 million, or 10% (Boivin et al, 2007) of couples, suffer from infertility, with a high proportion living in developing countries (Ombelet et al, 2008)
One (1) female partner and four (4) male partners tested positive for HBsAg in both cycles
Two (2) male partners who tested negative at the first IVF cycle tested positive for HBsAg in the second, despite the advice and the availability of the hepatitis B vaccine at the Public Health Unit of the hospital
Summary
Worldwide more than 70 million, or 10% (Boivin et al, 2007) of couples, suffer from infertility, with a high proportion living in developing countries (Ombelet et al, 2008). The inability to have children can have negative emotional, psychological and social impacts on the lives of these people (Ombelet et al, 2008; Rouchou, 2013). Secondary infertility has been shown to dominate over primary infertility in most developing countries, and this is a result of improperly treated sexually transmitted infections (STIs), resulting in pelvic inflammatory disease (PID) (Larsen et al, 2006; Elussein et al, 2008). It is estimated that 40 million people worldwide are living with HIV/AIDS and approximately two thirds of those live in sub-Saharan Africa (WHO, 2015). The national sero-prevalence of HIV was estimated to be 1.5%
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