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Bai M, Sun D, Shu J, Wei D, Yuan M, Yuan Z, Liu S, Kang M, Zhang Z, Chen X, Zheng W, Feng Y, Bao S, Zhang Z, Liao H. Assisted reproductive technology treatment failure and the detection of intrauterine HPV through spent embryo transfer media sample. J Med Virol 2024; 96:e29468. [PMID: 38415499 DOI: 10.1002/jmv.29468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/02/2024] [Accepted: 01/30/2024] [Indexed: 02/29/2024]
Abstract
Cervical human papillomavirus (HPV) infection is believed to increase the risks of pregnancy failure and abortion, however, whether the uterine cavity HPV infection reduces pregnancy rate or increases miscarriage rate remains unclarified in infertile women undergoing assisted reproductive technology (ART) treatment. Therefore, we aimed to assess ART outcomes in the presence of intrauterine HPV. This was a hospital-based multicenter (five reproductive medicine centers) matched cohort study. This study involved 4153 infertile women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection treatment in five reproductive medicine centers between October 2018 and 2020. The spent embryo transfer media sample with endometrium tissue were collected and performed with flow-through hybridization and gene chips to detect HPV DNA. According to basic characteristics, HPV-positive and negative patients were matched in a ratio of 1:4 by age, body mass index transfer timing, transfer type, and number of embryos transferred. The primary outcome was pregnancy and clinical miscarriage rates in the transfer cycle underwent HPV detection. 92 HPV-positive and 368 HPV-negative patients were screened and analyzed statistically. Univariate analysis showed uterine cavity HPV infection resulted in lower rates of ongoing pregnancy (31.5% vs. 44.6%; p = 0.023), implantation (32.3% vs. 43.1%; p = 0.026), biochemical pregnancy (47.8% vs. 62.5%; p = 0.010), and clinical pregnancy (40.2% vs. 54.3%; p = 0.015) compared with HPV negative group. The infertile female with positive HPV also had a slightly higher frequency of biochemical miscarriage (15.9% vs. 13.0%; p = 0.610) and clinical miscarriage (24.3% vs. 15.5%; p = 0.188). These findings suggest that HPV infection in the uterine cavity is a high risk for ART failure. HPV screening is recommended before ART treatment, which may be benefit to improving pregnancy outcome.
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Affiliation(s)
- Mingzhu Bai
- Reproductive Medicine Center, Department of Obstertrics and Gynecology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Center for Reproductive Medicine, Maternal and Child Health Hospital in Xuzhou, Xuzhou Medical University, Xuzhou, China
| | - Di Sun
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
- School of Medicine, Center for Reproductive Medicine & Fertility Preservation Program, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jinhui Shu
- Center for Reproductive Medicine, Maternal and Child Health Hospital in Guangxi, Guangxi, China
| | - Dong Wei
- Center for Reproductive Medicine, Liuzhou Worker's Hospital, Liuzhou, China
| | - Mu Yuan
- Center for Reproductive Medicine, Maternal and Child Health Hospital in Xuzhou, Xuzhou Medical University, Xuzhou, China
| | - Zhenya Yuan
- Center for Reproductive Medicine, Maternal and Child Health Hospital in Xuzhou, Xuzhou Medical University, Xuzhou, China
| | - Suying Liu
- Center for Reproductive Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mei Kang
- Center of Clinical Research, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Zikai Zhang
- Reproductive Medicine Center, Department of Obstertrics and Gynecology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiong Chen
- Department of Obstetrics and Gynecology, Shanghai Wusong Hospital, Shanghai, China
| | - Wenxin Zheng
- Department of Pathology and Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Youji Feng
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Shihua Bao
- Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhenbo Zhang
- Reproductive Medicine Center, Department of Obstertrics and Gynecology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Hong Liao
- Department of Laboratory Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
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Bruno MT, Caruso S, Scalia G, Costanzo M, Di Pasqua S, Boemi S, Panella MM, Palumbo M. Papillomavirus Infection as Potential Cause of Miscarriage in the Early Gestational Age: A Prospective Study. Diagnostics (Basel) 2023; 13:diagnostics13091659. [PMID: 37175050 PMCID: PMC10178196 DOI: 10.3390/diagnostics13091659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/25/2023] [Accepted: 05/01/2023] [Indexed: 05/15/2023] Open
Abstract
The possible association between human papillomavirus (HPV) infection and negative pregnancy outcomes has been debated in the literature, with conflicting results from clinical trials. While some authors support a link between HPV and miscarriage, others argue that the mere detection of the virus does not necessarily indicate a causal relationship with negative pregnancy outcomes. In this study, we conducted a prospective, controlled investigation of the potential association between HPV infection and miscarriage. Our study included 59 women who had experienced a miscarriage and 57 women who had undergone voluntary termination of pregnancy (TOP) within the 12th week of gestation. We assessed HPV prevalence, maternal age, and HPV genotype in both groups and evaluated the relationship between these factors and pregnancy outcome. Unlike previous studies that only identified HPV in cases of abortion, we also correlated the positivity of chorionic villi with gestational age in both groups. We found a close correlation between positive chorionic villi and very early gestational age, with all 13 cases of virus-positive chorionic villi in the miscarriage group occurring in gestational periods of less than 8 + 5 weeks (<60 days) (RR = 28.6). Our analysis showed no correlation between HPV infection and maternal age or viral genotypes. The results suggest that the presence of HPV alone is not enough to cause spontaneous abortion, but a high viral load in early pregnancy may increase the risk of negative outcomes. These findings have important implications for the management of HPV infection during pregnancy and may provide a rationale for the use of HPV vaccines to reduce the incidence of spontaneous abortion and infertility due to preclinical spontaneous abortions.
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Affiliation(s)
- Maria Teresa Bruno
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
| | - Salvatore Caruso
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
| | - Guido Scalia
- Department of Biomedical and Biotechnological Sciences, Clinical Virology, University of Catania, 95123 Catania, Italy
| | - Maria Costanzo
- Department of Biomedical and Biotechnological Sciences, Clinical Virology, University of Catania, 95123 Catania, Italy
| | - Salvatore Di Pasqua
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy
| | - Sara Boemi
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
| | - Marco Marzio Panella
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
| | - Marco Palumbo
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy
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Mazziotta C, Pellielo G, Tognon M, Martini F, Rotondo JC. Significantly Low Levels of IgG Antibodies Against Oncogenic Merkel Cell Polyomavirus in Sera From Females Affected by Spontaneous Abortion. Front Microbiol 2022; 12:789991. [PMID: 34970247 PMCID: PMC8712937 DOI: 10.3389/fmicb.2021.789991] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022] Open
Abstract
Merkel cell polyomavirus (MCPyV) is a small DNA tumor virus ubiquitous in humans. MCPyV establishes a clinically asymptomatic lifelong infection in healthy immunocompetent individuals. Viral infections are considered to be risk factors for spontaneous abortion (SA), which is the most common adverse complication of pregnancy. The role of MCPyV in SA remains undetermined. Herein, the impact of MCPyV infection in females affected by SA was investigated. Specifically, an indirect enzyme-linked immunosorbent assay (ELISA) method with two linear synthetic peptides/mimotopes mimicking MCPyV antigens was used to investigate immunoglobulin G (IgG) antibodies against MCPyV in sera from 94 females affected by SA [mean ± standard deviation (SD) age 35 ± (6) years] and from 96 healthy females undergoing voluntary pregnancy interruption [VI, mean (±SD) age 32 ± (7) years]. MCPyV seroprevalence and serological profiles were analyzed. The overall prevalence of serum IgG antibodies against MCPyV was 35.1% (33/94) and 37.5% (36/96) in SA and VI females, respectively (p > 0.05). Notably, serological profile analyses indicated lower optical densities (ODs) in females with SA compared to those undergoing VI (p < 0.05), thus indicating a reduced IgG antibody response in SA females. Circulating IgGs were identified in sera from SA and VI females. Our immunological findings indicate that a relatively reduced fraction of pregnant females carry serum anti-MCPyV IgG antibodies, while SA females presented a more pronounced decrease in IgG antibody response to MCPyV. Although yet to be determined, this immunological decrease might prompt an increase in MCPyV multiplication events in females experiencing abortive events. The role of MCPyV in SA, if present, remains to be determined.
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Affiliation(s)
- Chiara Mazziotta
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Center for Studies on Gender Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giulia Pellielo
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Mauro Tognon
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Fernanda Martini
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - John Charles Rotondo
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Center for Studies on Gender Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
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Bruno MT, Caruso S, Bica F, Arcidiacono G, Boemi S. Evidence for HPV DNA in the placenta of women who resorted to elective abortion. BMC Pregnancy Childbirth 2021; 21:485. [PMID: 34229658 PMCID: PMC8258985 DOI: 10.1186/s12884-021-03937-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is believed that HPV infection can result in the death of placental trophoblasts and cause miscarriages or preterm birth. In clinical cases of placental villi positive for HPV DNA reported by other authors, contamination is suspected in the act of crossing the cervical canal. We analyzed placental samples of women who resorted to elective abortion obtained by hysterosuction of ovular material, bypassing any contact with the cervical canal and vagina. METHODS We studied the chorionic villi of the placenta of 64 women who resorted to voluntary termination of pregnancy, in the first trimester. To avoid contamination of the villi by the cervical canal, we analyzed placental samples obtained by hysterosuction of ovular material, bypassing any contact with the cervical canal and vagina. All samples of chorionic villi were manually selected from the aborted material and subjected to research for HPV DNA. RESULTS HPV DNA was detected in 10 out of 60 women (16.6%). The HPV DNA identified in the placenta belonged to genotypes 6, 16, 35, 53, and 90. CONCLUSION The study shows that papillomavirus DNA can infect the placenta and that placenta HPV infection can occur as early as the first trimester of pregnancy.
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Affiliation(s)
- Maria Teresa Bruno
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, Catania, Italy.
| | - Salvatore Caruso
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, Catania, Italy
| | - Francesca Bica
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, Catania, Italy
| | - Giulia Arcidiacono
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, Catania, Italy
| | - Sara Boemi
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, Catania, Italy
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5
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Basonidis A, Liberis A, Daniilidis A, Petousis S, Dinas K. Human papilloma virus infection and miscarriage: is there an association? Taiwan J Obstet Gynecol 2021; 59:656-659. [PMID: 32917313 DOI: 10.1016/j.tjog.2020.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2020] [Indexed: 11/28/2022] Open
Abstract
Human papilloma virus (HPV) infection is the most common viral infection of the reproductive tract. HPV infection is more prevalent in pregnant than in age-matched non-pregnant women and its prevalence increases as pregnancy progresses. A number of reports evaluated the role of HPV infection in miscarriages. In the present review, we summarize the existing evidence regarding the association between HPV infection and miscarriage. It is still unclear whether HPV infection is associated with increased risk for miscarriage. Studies in the field yielded conflicting findings and their conclusions are limited by a small sample size and/or methodological limitations. On the other hand, preclinical data support a role of HPV infection in placental dysfunction. Given the high prevalence of HPV infection and the possibility that vaccination against HPV might protect against miscarriage, more studies are needed to elucidate whether this common infection is associated with increased risk for miscarriage.
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Affiliation(s)
- Alexandros Basonidis
- Second Department of Obstetrics and Gynecology, Medical School, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece
| | - Anastasios Liberis
- Second Department of Obstetrics and Gynecology, Medical School, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece.
| | - Angelos Daniilidis
- Second Department of Obstetrics and Gynecology, Medical School, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece
| | - Stamatis Petousis
- Second Department of Obstetrics and Gynecology, Medical School, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece
| | - Konstantinos Dinas
- Second Department of Obstetrics and Gynecology, Medical School, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece
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Tognon M, Tagliapietra A, Magagnoli F, Mazziotta C, Oton-Gonzalez L, Lanzillotti C, Vesce F, Contini C, Rotondo JC, Martini F. Investigation on Spontaneous Abortion and Human Papillomavirus Infection. Vaccines (Basel) 2020; 8:E473. [PMID: 32854278 PMCID: PMC7563606 DOI: 10.3390/vaccines8030473] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/03/2020] [Accepted: 08/12/2020] [Indexed: 02/07/2023] Open
Abstract
Viral infections are considered to be risk factors for spontaneous abortion (SA). Conflicting results have been reported on the association between Human Papillomavirus (HPV) and SA. HPV DNA was investigated in matched chorionic villi tissues and peripheral blood mononuclear cells (PBMCs) from women who experienced SA (n = 80, cases) and women who underwent a voluntary interruption of pregnancy (VI; n = 80, controls) by qualitative PCR and quantitative droplet digital PCR (ddPCR). Viral genotyping was performed using real-time PCR in HPV-positive samples. Specific IgG antibodies against HPV16 were investigated in sera from SA (n = 80) and VI (n = 80) females using indirect ELISA assays. None of the DNA samples from SA subjects was HPV-positive (0/80), whilst HPV DNA was detected in 2.5% of VI women (p > 0.05), with a mean viral DNA load of 7.12 copy/cell. VI samples (n = 2) were found to be positive for the HPV45 genotype. The ddPCR assay revealed a higher number of HPV-positive samples. HPV DNA was detected in 3.7% and 5% of SA and VI chorionic tissues, respectively, with mean viral DNA loads of 0.13 copy/cell in SA and 1.79 copy/cell in VI (p >0.05) samples. All DNA samples from the PBMCs of SA and VI females tested HPV-negative by both PCR and ddPCR. The overall prevalence of serum anti-HPV16 IgG antibodies was 37.5% in SA and 30% in VI (p > 0.05) women. For the first time, HPV DNA was detected and quantitatively analyzed using ddPCR in chorionic villi tissues and PBMCs from SA and VI women. Circulating IgG antibodies against HPV16 were detected in sera from SA and VI females. Our results suggest that HPV infection in chorionic villi may be a rare event. Accordingly, it is likely that HPV has no significant role in SA.
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Affiliation(s)
| | | | | | | | | | | | | | | | - John Charles Rotondo
- Department of Medical Sciences, University of Ferrara, Fossato di Mortara street, 64, 44121 Ferrara, Italy; (M.T.); (A.T.); (F.M.); (C.M.); (L.O.-G.); (C.L.); (F.V.); (C.C.)
| | - Fernanda Martini
- Department of Medical Sciences, University of Ferrara, Fossato di Mortara street, 64, 44121 Ferrara, Italy; (M.T.); (A.T.); (F.M.); (C.M.); (L.O.-G.); (C.L.); (F.V.); (C.C.)
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7
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Perrone AM, Bovicelli A, D'Andrilli G, Borghese G, Giordano A, De Iaco P. Cervical cancer in pregnancy: Analysis of the literature and innovative approaches. J Cell Physiol 2019; 234:14975-14990. [DOI: 10.1002/jcp.28340] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/20/2019] [Accepted: 01/24/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Anna Myriam Perrone
- Department of Obstetrics and Gynecology Unit of Oncologic Gynecology, S. Orsola‐Malpighi Hospital, University of Bologna Bologna Italy
| | - Alessandro Bovicelli
- Department of Obstetrics and Gynecology Unit of Oncologic Gynecology, S. Orsola‐Malpighi Hospital, University of Bologna Bologna Italy
| | - Giuseppina D'Andrilli
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University Philadelphia Pennsylvania
| | - Giulia Borghese
- Department of Obstetrics and Gynecology Unit of Oncologic Gynecology, S. Orsola‐Malpighi Hospital, University of Bologna Bologna Italy
| | - Antonio Giordano
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University Philadelphia Pennsylvania
- Department of Human Pathology and Oncology University of Siena Siena Italy
| | - Pierandrea De Iaco
- Department of Obstetrics and Gynecology Unit of Oncologic Gynecology, S. Orsola‐Malpighi Hospital, University of Bologna Bologna Italy
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