Persistence of Zika Virus in Gradient Sperm Preparation
Andrology-Open Access

Andrology-Open Access
Open Access

ISSN: 2167-0250

+44 1300 500008

Case Report - (2017) Volume 6, Issue 2

Persistence of Zika Virus in Gradient Sperm Preparation

Nino Guy Cassuto1*, Giulia Marras2, Véronique Jacomo1 and Dominique Bouret1
1ART Unit Drouot Laboratory, 21 rue Drouot – 75009 Paris, France
2Biomnis Laboratory, 17-19 Avenue Tony Garnier-BP 7322 - 69357 Lyon cedex 07, France
*Corresponding Author: Nino Guy Cassuto, ART Unit Drouot Laboratory, 21 Rue Drouot – 75009 Paris, France, Tel: +33611620105, Fax: +33147707779 Email:


In April 2016 ZIKA virus RNA was detected during control before performing in vitro fertilization in adult-man semen that contracted the infection in French Guyana and travel back to France. The infection had been detectable in the sperm by qRT-PCR and the virus persists in the semen even after routinely ART sperm migration performed in a bilayer gradient. Zika virus (ZIKV) is an arbovirus transmitted by Aedes aegypti mosquitos. The virus has spread rapidly in the A. aegypti endemic region (South America, Central America, the Caribbean, the Pacific islands, Singapore, and Thailand) but the ability of ZIKV to be transmitted sexually has enhanced the transmission of the disease in non-endemic countries. It has been reported that during pregnancy ZIKV infection can lead to developmental abnormalities (microcephaly, cerebral calcification, fetal loss) and that the virus is also associated with Guillain-Barré syndrome. Guidelines have been drawn up regarding patients who come from countries affected by ZIKV epidemic and who intend to use Assisted Reproductive Technology (ART). The international guidelines impose analysis for ZIKV detection in blood, urine and semen of the patient resident in or travelling back from ZIKV endemic countries in a 6-month-span. These screening analyses must be performed in semen before ART procedures.


Keywords: Zika virus; Blood; Semen

Case Study

We report a case of a French man coming to Paris from Guyana, an endemic area, to perform ART for cryptozoospermia diagnostic [1]. The patient described an episode of symptoms compatible with ZIKV which occurred 1 month before his arrival in France: high fever (temperature around 40°C), cephalgia, myalgia and arthralgia.

His illness lasted 5 days and he had no symptoms of itchy rash and prostatitis or gross hematospermia. In our laboratory we collected and frozen his semen before the ART attempt [2-5]. The first standard serologic analysis (HCV, HBV, HIV, TPHA) were negative. But the ZIKV detection was positive by rRT-PCR in both: Total sperm and in the sperm fraction used in ART after bilayer gradient centrifugation. Second tests performed 10 days later detected IgG and IgM in the serum and ZIKV RNA was always present in sperm bilayer gradient preparation. Other control tests have been performed both in ejaculated sperm and in a sperm selected fraction resulting positive. These results have been confirmed by Arbovirus CNR (Marseille). The first negative result appeared on the 112th day after the onset of symptoms.


According to our knowledge this is the first report in which the ZIKV persists in the fraction. The characteristics of spermatozoa infection and the time window of risk of sexual transmission are still on debate and the detection of ZIKV on sperm head by immunohistochemistry has been showed [6].

The viral persistence in semen is one of the key issues and until a solution to this matter can’t be found it would be better to follow specific measures of prevention, specifically in the ART procedures. Usually in ART the semen preparation by bilayer density gradient centrifugation coupled to the intra-cytoplasmic sperm injection (ICSI) largely decreases the transmission risk to viruses. We know that HCV isn’t present in the last fraction used for ART [7] invers the ZIKV persist in this fraction like HIV and HBV [8].


Before including a couple coming from endemic area in IVF program it’s mandatory to perform a deeply virus research not only in the total sperm but in the last sperm fraction used in ART.


  1. Gornet ME, Bracero NJ, Segars JH (2016) Zika Virus in Semen: What We Know and What We Need to Know SeminReprod Med 34: 285–292.
  2. Weaver SC, Costa F, Garcia-Blanco MA, Ko AI, Ribeiro GS, et al. (2016) Zika virus: History, emergence, biology, and prospects for control Antiviral Res 130: 69–80.
  3. Cao-Lormeau VM (2016) Guillain-Barré Syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study Lancet Lond. Engl 387: 1531–1539.
  4. Dossier SP, Pole SQ (2017) Professional recommendations in the framework of the Zika virus epidemic - Agence de la
  5. Mansuy JM (2016) Zika virus in semen and spermatozoa Lancet Infect Dis 16: 1106–1107.
  6. Cassuto NG, Sifer C, Feldmann G, Bouret D, Moret F (2002) A modified RT-PCR technique to screen for viral RNA in the semen of hepatitis C virus-positive men Hum. Reprod. Oxf. Engl 17: 3153–3156.
  7. Jindal SK, Rawlins RG, Muller CH, Drobnis EZ (2016) Guidelines for risk reduction. When handling gametes from infectious patients seeking assisted reproductive technologies. Reprod Biomed Online 33: 121–130.
Citation: Cassuto NG, Marras G, Jacomo V, Bouret D (2017) Persistence of Zika Virus in Gradient Sperm Preparation. Andrology (Los Angel) 6: 186.

Copyright: © 2017 Cassuto NG, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.