Seminal human papillomavirus originates from the body surface and is not a frequent aetiological factor in azoospermia.

Jens Fedder,Thomas Kielsgaard Kristensen,Dorthe Ørnskov,Birte Engvad,Mads Lomholt,Niels Marcussen,Marianne Waldström

doi:10.1111/and.13202

Jens Fedder, Thomas Kielsgaard Kristensen + Show 5 more

Open Access

https://doi.org/10.1111/and.13202

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Abstract

Human papillomavirus (HPV) DNA has been detected in the testis tissue of 6.5% of 185 men with non‐obstructive azoospermia (NOA). Others have suggested that seminal HPV originates from contamination from the genital skin and mucosa. One hundred unselected azoospermic men and 43 normal men undergoing vasectomy were recruited. Testicular biopsies for HPV examination were collected from all the men. Additionally, the normal men undergoing vasectomy delivered a semen sample and had a swab for HPV examination taken from the genital skin before vasectomy. A piece of each Vas deferens obtained during the vasectomy was examined for the presence of HPV. Two of the primarily azoospermic men were shown to have cryptozoospermia. It was not possible to detect HPV in the testis tissue of any of the included 98 azoospermic men or the 43 proven fertile men. In the proven fertile men, HPV DNA was detected in the semen of 15 men (35%), on the genital skin of 28 men (65%), and in the Vas deferens in three cases (7%). In 13 (87%) men with HPV‐positive semen samples, HPV DNA was also detected in the skin swabs, and in 11 men (73%), identical HPV genotypes were found in the two locations.

Highlights

Azoospermia is found in 5%–20% of men suffering from infertil‐ ity (Kolettis, 2002) and in 1%–2% of the overall population (Jarow, Espeland, & Lipschultz, 1989)
In 13 (87%) men with Human papillomavirus (HPV)‐positive semen samples, HPV DNA was detected in the skin swabs, and in 11 men (73%), identical HPV genotypes were found in the two locations
HPV DNA was detected on the genital skin of 2/3 and in the semen in 1/3 of the healthy men

Summary

| INTRODUCTION

Azoospermia is found in 5%–20% of men suffering from infertil‐ ity (Kolettis, 2002) and in 1%–2% of the overall population (Jarow, Espeland, & Lipschultz, 1989). To the best of our knowledge, the study by Martorell et al (2005) is the only previous study examining the presence of HPV in testis tissue, and it might suggest that HPV could be an aetiological factor in men in whom azoospermia until now has remained unexplained. Studies have suggested that seminal HPV originates from uro‐ genital tract reservoirs (Damke et al, 2017) or from genital skin or mu‐ cosa (Giovannelli et al, 2007; Golob et al, 2014; Luttmer et al, 2015). Possible seminal “HPV contamination” from the genital skin and mu‐ cosa is supported by near associations between HPV types detected in the semen and on genital skin (Golob et al, 2014; Luttmer et al, 2015). Associations between the presence of HPV in testicular tissue, the Vas deferens pieces removed by vasectomy, genital skin and semen

| Study design and subjects

Findings

| DISCUSSION