Cytomegalovirus infection and male infertility: case report

Abstract

Objectives. To present a case report of male infertility associated with cytomegalovirus infection and the outcome of antiviral treatment.Clinical observation. A 31-year-old man presented with a history of 6 years of infertility. No pathology was revealed in his wife. High loads of cytomegalovirus (CMV) were detected by PCR: in expressed prostatic secretion (EPS)  8700 copies/ml, in ejaculate – 598 440 copies/ml. Sperm examination revealed necrozoospermia and leukospermia. CMV-associated accessory gland infection was verified. The patient was treated with valacyclovir 500 bid for 90 days and interferon α2β suppository (Viferon®) 1 million IU for 30 days. All sperm parameters improved in 1 month after initiation of antiviral treatment. Sperm concentration and motility increased × 1.5 and × 1.4 respectively, sperm viability and leukocyte count achieved reference values.  At the same time, CMV loads decreased: EPS to 300 copies/ml, the ejaculate to 54 000 copies/ml. After 3 months  (by the end of the antiviral treatment): EPS-negative, the ejaculate – 6060 copies/ml; after 6 months: EPS – negative, the ejaculate 3900 copies/ml. Within 6 months, the woman became pregnant and gave birth to a healthy baby girl. After 3 years, there was a second pregnancy and the birth of a healthy boy.Conclusion. The male factor has been established as the cause of infertility in a married couple; the only probable etiological agent of pathozoospermia was cytomegalovirus infection. The use of complex antiviral and immunotherapy (interferon α2β with antioxidants, Viferon®) provided positive dynamics in clinical, sperm and laboratory parameters, which led to the conception and birth of two children.