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Effects of antiretroviral therapy on semen quality

van Leeuwen, Elisabetha,c; Wit, Ferdinand Wb,c; Repping, Sjoerda; Eeftinck Schattenkerk, Jan Karel Mc; Reiss, Peterb,c; van der Veen, Fulcoa; Prins, Jan Mc

doi: 10.1097/QAD.0b013e3282f4de10
Epidemiology and Social: Concise Communication

Objective: To evaluate the effect of combination antiretroviral therapy (cART) on semen quality.

Design: A longitudinal cohort study.

Setting: The HIV outpatient clinic of the Academic Medical Centre in Amsterdam, the Netherlands.

Subjects: A cohort of 34 male patients with different estimated duration of HIV-1 infection, who were about to start various combinations of cART.

Intervention(s): Blood and semen analyses before the start of cART and 4, 12, 24, 36 and 48 weeks thereafter.

Main outcome measure(s): We examined the effect of cART on semen parameters by a repeated measurements procedure using a mixed-effects model.

Results: The median period of follow up was 48 weeks (interquartile range 33–52 weeks). Five patients used thymidine analogue-containing cART, 23 used tenofovir-based cART, six used other regimens. At all timepoints the percentage of progressively motile spermatozoa was low according to WHO criteria, and it decreased significantly from 28 to 17% during follow-up (P = 0.02). All other semen parameters were in the normal range and remained stable.

Conclusion: cART negatively affected the percentage of progressively motile spermatozoa. Whether this reduced motility affects the chances of fathering a child or leads to an increased need for artificial reproductive techniques is at present unknown.

From the aCentre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, the Netherlands

bCentre for Poverty-related Communicable Diseases, Academic Medical Centre, Amsterdam, the Netherlands

cDepartment of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, and Centre for Infection and Immunity Amsterdam (CINIMA), Academic Medical Centre, Amsterdam, the Netherlands.

Received 9 August, 2007

Revised 24 October, 2007

Accepted 31 October, 2007

Correspondence to Elisabeth van Leeuwen, Academic Medical Centre, Obstetrics and Gynaecology, H4-205, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands. Tel: +31 020 5663753; fax: +31 020 6963489; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.