Assisted reproductive technology treatment failure and the detection of intrauterine HPV through spent embryo transfer media sample

Mingzhu Bai; Di Sun; Jinhui Shu; Dong Wei; Mu Yuan; Zhenya Yuan; Suying Liu; Mei Kang; Zikai Zhang; Xiong Chen; Wenxin Zheng; Youji Feng; Shihua Bao; Zhenbo Zhang; Hong Liao

doi:10.1002/jmv.29468

Assisted reproductive technology treatment failure and the detection of intrauterine HPV through spent embryo transfer media sample

J Med Virol. 2024 Mar;96(3):e29468. doi: 10.1002/jmv.29468.

Authors

Mingzhu Bai^{1

2}, Di Sun^{3

4}, Jinhui Shu⁵, Dong Wei⁶, Mu Yuan², Zhenya Yuan², Suying Liu⁷, Mei Kang⁸, Zikai Zhang¹, Xiong Chen⁹, Wenxin Zheng^{10

11}, Youji Feng³, Shihua Bao¹², Zhenbo Zhang^{1

13}, Hong Liao¹⁴

Affiliations

¹ Reproductive Medicine Center, Department of Obstertrics and Gynecology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
² Center for Reproductive Medicine, Maternal and Child Health Hospital in Xuzhou, Xuzhou Medical University, Xuzhou, China.
³ Department of Obstetrics and Gynecology, Reproductive Medicine Center, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China.
⁴ School of Medicine, Center for Reproductive Medicine & Fertility Preservation Program, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, China.
⁵ Center for Reproductive Medicine, Maternal and Child Health Hospital in Guangxi, Guangxi, China.
⁶ Center for Reproductive Medicine, Liuzhou Worker's Hospital, Liuzhou, China.
⁷ Center for Reproductive Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
⁸ Center of Clinical Research, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China.
⁹ Department of Obstetrics and Gynecology, Shanghai Wusong Hospital, Shanghai, China.
¹⁰ Department of Pathology and Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
¹¹ Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
¹² Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
¹³ Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.
¹⁴ Department of Laboratory Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.

PMID: 38415499
DOI: 10.1002/jmv.29468

Abstract

Cervical human papillomavirus (HPV) infection is believed to increase the risks of pregnancy failure and abortion, however, whether the uterine cavity HPV infection reduces pregnancy rate or increases miscarriage rate remains unclarified in infertile women undergoing assisted reproductive technology (ART) treatment. Therefore, we aimed to assess ART outcomes in the presence of intrauterine HPV. This was a hospital-based multicenter (five reproductive medicine centers) matched cohort study. This study involved 4153 infertile women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection treatment in five reproductive medicine centers between October 2018 and 2020. The spent embryo transfer media sample with endometrium tissue were collected and performed with flow-through hybridization and gene chips to detect HPV DNA. According to basic characteristics, HPV-positive and negative patients were matched in a ratio of 1:4 by age, body mass index transfer timing, transfer type, and number of embryos transferred. The primary outcome was pregnancy and clinical miscarriage rates in the transfer cycle underwent HPV detection. 92 HPV-positive and 368 HPV-negative patients were screened and analyzed statistically. Univariate analysis showed uterine cavity HPV infection resulted in lower rates of ongoing pregnancy (31.5% vs. 44.6%; p = 0.023), implantation (32.3% vs. 43.1%; p = 0.026), biochemical pregnancy (47.8% vs. 62.5%; p = 0.010), and clinical pregnancy (40.2% vs. 54.3%; p = 0.015) compared with HPV negative group. The infertile female with positive HPV also had a slightly higher frequency of biochemical miscarriage (15.9% vs. 13.0%; p = 0.610) and clinical miscarriage (24.3% vs. 15.5%; p = 0.188). These findings suggest that HPV infection in the uterine cavity is a high risk for ART failure. HPV screening is recommended before ART treatment, which may be benefit to improving pregnancy outcome.

Keywords: HPV; assisted reproductive technology; miscarriage; pregnancy outcomes; uterine cavity.

Publication types

Multicenter Study

MeSH terms

Abortion, Spontaneous*
Cohort Studies
Embryo Transfer / methods
Female
Fertilization in Vitro
Human Papillomavirus Viruses
Humans
Infertility, Female* / therapy
Male
Papillomavirus Infections* / diagnosis
Pregnancy
Reproductive Techniques, Assisted
Semen
Treatment Failure

Abstract

Publication types

MeSH terms

Grants and funding