O-016 Semen human papilloma virus and in vitro fertilization: Machine learning insights into infection prevalence and embryologic outcomes

Abstract

Abstract Study question What is prevalence of human papilloma virus in semen from men undergoing in vitro fertilization in Sweden and how is it associated with semen parameters? Summary answer Among the included men, 8.9% tested positive for HPV. No significant differences in semen parameters were found between HPV-negative and HPV-positive men. What is known already HPV is the most common sexually transmitted viral infection, with well-documented epidemiology in women. However, data on HPV prevalence in men remain limited. Emerging evidence suggests that HPV is more prevalent in semen from infertile men than in fertile individuals and may negatively impact sperm motility, quality, and DNA integrity. While high-risk HPV types are linked to male infertility, inconsistencies in study methodologies have led to conflicting findings. Study design, size, duration This prospective cohort study was conducted at Sahlgrenska University Hospital, Gothenburg, Sweden, between January 2023 and February 2024. A total of 246 men undergoing IVF with autologous gametes provided fresh semen samples for HPV testing, while 182 their female partners consented to clinical data collection. Participants/materials, setting, methods The study included 288 men undergoing IVF/ICSI at the Division of Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. After exclusions due to consent withdrawal, insufficient semen volume, or lack of retrieved oocytes, 246 participants remained. Semen samples were analyzed following WHO guidelines, and HPV DNA was detected using real-time PCR. Embryo quality was assessed based on the Istanbul Consensus criteria. Data were analyzed using conventional statistics and machine learning algorithms to improve predictive accuracy. Main results and the role of chance Among the 246 men, 8.9% tested positive for HPV. No significant differences in semen parameters were found between HPV-negative and HPV-positive men. However, in the non-male infertility subgroup, HPV-positive men exhibited significantly higher total motility (median 65% vs. 60%, p = 0.021) and progressive motility (median 65% vs. 55%, p = 0.016). Similarly, in the unexplained infertility subgroup, HPV-positive men had higher progressive motility (median 60% vs. 50%, p = 0.033). No significant differences were observed in fertilization or blastocyst formation rates. Machine learning models demonstrated that HPV presence had no impact on predictive accuracy. Overall, these findings suggest that while HPV is detectable in semen, it does not significantly impact semen quality or embryological outcomes. The statistical significance observed in motility differences within subgroups indicates potential associations, but further research is needed to clarify HPV’s reproductive effects. Limitations, reasons for caution Although the sample size was adequate for HPV prevalence estimation, it may not be generalizable. The study was not powered to assess live birth or miscarriage rates. Lack of post-preparation HPV analysis limits conclusions on embryo quality. Machine learning models depend on data quality and may introduce biases. Wider implications of the findings The low prevalence of HPV in semen and its lack of impact on embryological outcomes suggest that routine HPV screening may not be necessary in IVF settings. However, observed differences in sperm motility challenge existing assumptions, warranting further research on HPV-sperm interactions and potential effects in specific subgroups. Trial registration number Yes

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