Previous reports have reported less consistent effects. One study found only ejaculate volume to be correlated with CD4 cell count, but sperm concentration and total sperm AZD1208 in vitro count were lower in those men with CD4 count<200 cells/μL [14]. Two studies found CD4 cell count to correlate only with motility [12,17], while two others found CD4 cell count to positively correlate with motility and negatively correlate with abnormal morphology [13,15]. Although

the exact data were not presented, a further report demonstrated no effect of CD4 count on any parameter using a cut-off of 500 cells/μL [26]. An effect of CD4 cell count on these parameters is supported by studies reporting that a diagnosis of AIDS [11,15] and disease progression

[by Centers for Disease Control and Prevention (CDC) clinical categories [15] significantly affects spermatogenesis. PD0325901 ic50 Unlike a report of a correlation between VL and type ‘b’ motility and sperm morphology [14] and another of a lower progressive motility in those with detectable VL [26], we found that VL had no effect on any parameter. Several small series reported no difference in any parameter in those taking antiretroviral medication [11–13,17,26], but many are hampered by small sample numbers. In contrast, we demonstrate that samples taken from men on HAART have significantly impaired sperm count, motility and morphology and a lower number of motile sperm available for use for insemination cycles post sperm washing. In view of the benefit of stable, well-controlled disease, as demonstrated by the relationship between CD4 cell count

and sperm parameters, it might have been expected that there would be a similar benefit of GNA12 undetectable VL. However, our data suggest that any such potential benefit is counterbalanced by the effect of commencing HAART. The effect of antiretrovirals remains difficult to separate from the effect of HIV infection, and few studies have prospectively assessed the effect of treatment. One report found that those on zidovudine treatment, regardless of disease stage, had parameters similar to those of untreated early disease stage patients [16]. One study assessed 26 men about to start treatment for 12 weeks, and reported an overall increase in sperm motility and normal morphology, with no effect on sperm count [27]. A case report of a sperm donor who seroconverted during the course of donation demonstrated a reduction in semen volume, sperm motility and percentage of spermatozoa with normal morphology following infection over a course of 18 months [28].