OBJECTIVE To analyze the effect of human papilloma virus (HPV) sperm infection on sperm parameters and in vitro fertilization (IVF) outcomes. DESIGN Systematic review and meta-analysis. SETTING Not applicable. PATIENTS Men with HPV sperm infection and couples undergoing IVF. INTERVENTIONS Searches were conducted in the following databases: Medline(R), PubMed, Embase, Web of Science, Scopos, and the Cochrane Library. We included studies examining sperm parameters and IVF results in patients with and without HPV sperm infection. MAIN OUTCOME MEASURES Sperm analysis (concertation, count, volume, motility, morphology), according to the World Health Organization manual, pregnancy rate (PR), and miscarriage rate (MR). RESULTS Sixteen studies were included in this meta-analysis. The presence of HPV had a significant association with impaired sperm parameters in terms of concentration (mean difference [MD] -4.48, 95% confidence interval [CI] - 6.12 to -2.83), motility (MD -11.71, 95% CI - 16.15 to -7.26), and morphology (MD -2.44, 95% CI - 4.08 to -0.79. A review of the literature regarding ART outcomes showed an association between HPV infection and decreased PR, and an even stronger association between HPV infection and increased MR. CONCLUSION Our meta-analysis shows a negative effect of HPV on sperm concentration, motility, and morphology. Further subgroup and categorical analysis confirmed the clinical significance of impaired sperm motility in HPV-infected sperm, although the sperm count and morphology must be carefully analyzed. The studies reviewed reported lower PR and increased MR in couples with HPV-infected sperm. As most studies had a moderate risk of bias, these observations warrant further large, well-designed studies before introducing clinical management recommendations. PROSPERO REGISTRATION NUMBER CRD42019127419.

中文翻译：

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评估精液中的人乳头瘤病毒作为精子质量低下和体外受精结果差的危险因素：系统评价和荟萃分析

目的分析人乳头瘤病毒（HPV）精子感染对精子参数和体外受精（IVF）结果的影响。设计系统评价和荟萃分析。设置 不适用。患者 患有 HPV 精子感染的男性和接受试管婴儿的夫妇。干预 在以下数据库中进行了检索：Medline(R)、PubMed、Embase、Web of Science、Scopos 和 Cochrane 图书馆。我们纳入了检查有和没有 HPV 精子感染患者的精子参数和 IVF 结果的研究。主要结果测量 根据世界卫生组织手册、妊娠率 (PR) 和流产率 (MR) 进行的精子分析（浓度、计数、体积、活力、形态）。结果 本荟萃分析包括 16 项研究。审查的研究报告称，感染 HPV 的精子的夫妇 PR 较低，MR 增加。由于大多数研究具有中等偏倚风险，因此在引入临床管理建议之前，这些观察结果需要进一步的大型、精心设计的研究。PROSPERO 注册号 CRD42019127419。