Intracytoplasmic sperm injection with microsurgically retrieved spermatozoa in azoospermic men infected with human immunodeficiency virus 1 or hepatitis C virus The EP43 AZONECO ANRS study

Capsule:
Density gradient and washing can remove HCV RNA or HIV RNA from microsurgical epididymal sperm aspiration or testicular sperm extraction samples obtained from HCV- or HIV-infected azoospermic men before ICSI.

Authors:
Marianne Leruez-Ville, Ph.D., Nicolas Thiounn, M.D., Catherine Poirot, M.D., Odile Launay, Ph.D., Philippe Sogni, M.D., Sophie Grabar, Ph.D., Emmanuel Dulioust, Ph.D.

Volume 99, Issue 3, Pages 713-717, 1 March 2013

Abstract:

Objective:
To evaluate the viral contamination of sperm obtained after testicular sperm extraction (TESE) and microsurgical epididymal sperm aspiration (MESA) in men with azoospermia and HIV or HCV infection.

Design:
Prospective study.

Setting:
Fertility clinic, reproductive technology and virology laboratories.

Patients:
Six men with azoospermia: 2 HIV-1 infected with undetectable blood viral load and 4 HCV infected with detectable blood viral load.

Intervention:
Processing by gradients density centrifugation and washing of surgically recovered sperm (TESE and MESA); virological analysis; in vitro fertilization (with intracytoplasmic sperm injection (ICSI)

Main Outcome Measures:
Detection of HIV-1 RNA or HCV RNA in gradient supernatants, testis tissues and final processed spermatozoa and of HIV-1 DNA in testis tissues.

Results:
Gradient supernatants and testis tissues tested HCV RNA positive in all cases while processed spermatozoa always tested negative. Gradient supernatants, testis tissues and processed spermatozoa tested HIV-1 RNA negative. HIV-1 DNA was detectable in one testis tissue. All female partners tested HCV or HIV negative after ICSI.

Conclusions:
Density gradient and washing suppressed virus detection in final suspensions of testicular and epididymal spermatozoa. ICSI after MESA or TESE appears to be feasible and could be offered in azoospermic men infected by HCV or HIV.

  • NicoGarrido

    Dear Dr Leruez-Ville,

    congratulations for your nice work. Given the very scarce information available regarding these cases, and the high % of patients potentially infected with either HIV or HCV or both, without sperm cells in the ejaculate, any contribution is welcomed.

    This may lead to the clinics to accept these kind of patients, under controlled conditions, given that the evidences available to date regarding sperm washes (mainly from ejaculated samples), and now TESE obtained, tissue support the use of these protocols.
    Best regards
    Nico

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