Biochemical indicators of sperm plasma and morphofunctional features of spermatozoa in HIV-infected men

Abstract

BACKGROUND: The problem of male infertility particularly affects men with HIV infections, as semen volume and sperm motility are reduced by highly active antiretroviral therapy. AIM: To analyze the metabolic parameters of spermatozoa, spermograms and spermatozoa morphology in HIV-infected men. MATERIALS AND METODS: The study included 47 patients (aged 2546 years) who were under observation at the clinic of Professor M.A. Florova (Samara). 2 groups were formed: main (n=22) HIV-infected patients who want to have children (with an undetectable viral load (4050 copies/ml) and taking antiretroviral therapy); control (n=25) clinically healthy men with one child. The material was taken and the ejaculate was examined according to standardized methods proposed by WHO experts. RESULTS: In HIV-infected men, spermatozoa motility was low (the number of progressively motile spermatozoa was 28.503.72%), the spermatozoa concentration was two times lower compared to the control group of men, the morphological characteristics of spermatozoa were significantly worse than in the control group: most often pathology of the head (21.751.10%) and neck of the spermatozoon (22.301.18%) was detected, which negatively affects the fertilizing ability. In HIV-infected men, changes in metabolic metabolism were noted: the activity of creatine phosphokinase in both sperm plasma (661.951.08 U/l) and blood plasma (76.901.09 U/l) was lower, than in the control group (844.250.13 and 79.501.37 U/l, respectively), the glucose concentration (8.071.14 mmol/l) was 2 times higher than in the control group (3.061.09 mmol/l), the concentration of calcium 6.530.01 and sodium (119.201.23 mol/l) slightly exceeded those in the group of healthy patients (5.550.08 and 116.850.01 mol/l, respectively). Electron microscopic analysis revealed fragmentation of sperm DNA: the highest percentage of sperm with fragmented DNA was found in men with HIV infection (more than 23%). CONCLUSION: It was revealed that in vivo fertilization in HIV-infected men is impossible in most cases. The study forms the basis for a future comprehensive assessment of the state of reproductive function in HIV-infected men to assess their fertility and the need for assisted reproductive technologies.