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

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 25–46 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 (40–50 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 28.50±3.72%), 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 (21.75±1.10%) and neck of the spermatozoon (22.30±1.18%) 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 (661.95±1.08 U/l) and blood plasma (76.90±1.09 U/l) was lower, than in the control group (844.25±0.13 and 79.50±1.37 U/l, respectively), the glucose concentration (8.07±1.14 mmol/l) was 2 times higher than in the control group (3.06±1.09 mmol/l), the concentration of calcium 6.53±0.01 and sodium (119.20±1.23 mol/l) slightly exceeded those in the group of healthy patients (5.55±0.08 and 116.85±0.01 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.