Abstract
The human papillomavirus (HPV) is a sexually transmitted infection common among men and women across all geographic and socioeconomic subgroups worldwide. Recent evidence suggests that HPV infection may affect fertility and alter the efficacy of assisted reproductive technologies. In men, HPV infection can affect sperm parameters, specifically motility. HPV-infected sperm can transmit viral DNA to oocytes, which may be expressed in the developing blastocyst. HPV can increase trophoblastic apoptosis and reduce the endometrial implantation of trophoblastic cells, thus increasing the theoretical risk of miscarriage. Vertical transmission of HPV during pregnancy may be involved in the pathophysiology of preterm rupture of membranes and spontaneous preterm birth. In patients undergoing intrauterine insemination for idiopathic infertility, HPV infection confers a lower pregnancy rate. In contrast, the evidence regarding any detrimental impact of HPV infection on IVF outcomes is inconclusive. It has been suggested that vaccination could potentially counter HPV-related sperm impairment, trophoblastic apoptosis, and spontaneous miscarriages; however, these conclusions are based on in vitro studies rather than large-scale epidemiological studies. Improvement in the understanding of HPV sperm infection mechanisms and HPV transmission into the oocyte and developing blastocyst may help explain idiopathic causes of infertility and miscarriage.
Highlights
The human papillomavirus (HPV) is one of the most common sexually transmitted viruses worldwide [1, 2]
In vitro fertilization Women with HPV infection had a lower pregnancy rate compared to women without the infection Higher odds of spontaneous miscarriage among women with HPV infection, as well as in women whose male partners were HPV positive No statistical difference in live birth rate when comparing HPV positive women compared to negative controls No effect of HPV on clinical pregnancy and spontaneous miscarriage rates while the corresponding figure in men with unexplained infertility ranges between 10 and 35.7% [54]
HPV is most widely known for its link to various cancers, recent evidence suggests an association with infertility and adverse pregnancy outcomes
Summary
The human papillomavirus (HPV) is one of the most common sexually transmitted viruses worldwide [1, 2]. As recently as 1970, HPV was thought to be a single type that caused warty lesions at different tissue sites [3]. With the advent of recombinant DNA technology, it became evident that many different types of HPV existed, some of which were carcinogenic [3]. Infection with HPV is known to affect other aspects of human health as well. Recent evidence suggests that HPV infection may affect fertility and alter the efficacy of assisted reproductive technologies [4, 5]. The current review appraises the recent medical literature pertaining to the epidemiology, immunobiology, and impact of HPV infection on normal reproductive function. The paper critically evaluates the current evidence related to HPV infection and fertility alteration, as well as its impact on assisted reproductive pregnancy rates
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