Abstract
BackgroundCurrent evidence about in-vivo effects of HPV cannot definitively clarify the possible negative role of this worldwide common infection in early embryo development. However in-vitro evidence, seems to underline a possible negative effect of HPV in increasing blastocyst apoptosis and in reducing the endometrial implantation of trophoblastic cells. On these bases we believe that a new scientific approach is necessary to better understand the real role of male and female HPV infection in infertility and early pregnancy development.MethodsEnglish literature review of manuscripts focused on HPV infection and human reproduction was conducted. We performed a critical analysis of evidence and possible bias affecting both in-vivo and in-vitro studies regarding this topic.ResultsThe biggest limitation of the in-vivo studies is due to the inappropriate timing of HPV effects evaluation since evidence about in-vitro studies strongly suggests that a large part of HPV negative effects occurs during a very early stage of embryo development. All the efforts of the scientific community to investigate the real role of HPV in human reproduction disorders cannot underestimate the severe BIAS of actual evidence in postulating new hypothesis and research projects which are fundamental to clarify if HPV may be associated with unexplained couples infertility and early miscarriages.ConclusionsIf the relationship between HPV gametes infection and early human reproduction step impairment will be confirmed, the HPV male and couple vaccination may represent a reliable option to improve fertility in some couples affected by infertility actually classified as “idiopathic” but maybe linked to HPV infection.
Highlights
Current evidence about in-vivo effects of HPV cannot definitively clarify the possible negative role of this worldwide common infection in early embryo development
Starting from our recent systematic literature review about “Male and Couple Fertility Impairment due to HPV-DNA Sperm Infection” we focused our attention on the controversies concerning HPV infection in human reproduction impairment [1]
The third BIAS is related to the fact that all these studies are built without considering the new inputs provided by recent in-vitro evidence which demonstrated that HPV sperm infection seems to have a possible role in adverse blastocyst development [7,14]
Summary
Current evidence about in-vivo effects of HPV cannot definitively clarify the possible negative role of this worldwide common infection in early embryo development. In-vitro evidence, seems to underline a possible negative effect of HPV in increasing blastocyst apoptosis and in reducing the endometrial implantation of trophoblastic cells. On these bases we believe that a new scientific approach is necessary to better understand the real role of male and female HPV infection in infertility and early pregnancy development. On a total of 199 couples undergoing to IVF cycles (in-vitro fertilization), found an increased risk of pregnancy loss both in case of male sperm infection (66.7% versus 15%) and of female cervical infection (40% versus 13.7%) [3]. Ticconi et al, analyzing retrospectively 49 cases of women with unexplained recurrent miscarriages and 475 healthy controls, found a cervical HPV prevalence of 26.53% in cases (13 of 49) and 61.89% in controls (294 of 475) confirming the absence of a causal association between HPV and miscarriages [6]
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