I have contracted HPV. Will this affect my fertility?

• Human papillomavirus (HPV) affects both women and men, with different implications for their fertility, especially when co-infected with chlamydia
• In women, HPV can cause lesions such as scarring, adhesions, or blockages in the fallopian tubes, while in men, it can impact sperm quality, motility, or even lead to DNA fragmentation
• There is also an increased risk of miscarriage due to reduced embryo implantation capacity in the uterine wall and premature birth, but these risks depend on the subtype of HPV contracted

VALENCIA, September 3, 2024

From our first sexual encounter, we are all exposed to the virus from the Papillomaviridae family, commonly known as HPV. This virus (of which there are more than 150 genotypes) can cause warts or high-grade lesions and even cervical cancer, primarily caused by strains or serotypes 16 and 18, responsible for 70% of cervical cancer cases.

Approximately 80% of sexually active women will come into contact with at least one subtype of HPV at some point in their lives. However, these infections are usually temporary and typically resolve spontaneously within a variable period of time after exposure in the vast majority of cases. Nonetheless, this virus can also remain inactive or dormant for quite some time and can manifest even years after the initial transmission. 

“Many women come to the clinic concerned about whether this infection could affect their ability to conceive and carry a pregnancy to term. However, it’s important to clarify that this virus does not cause infertility on its own. Some studies suggest that only when co-infected with chlamydia does the risk of sterility increase. We also observe a higher risk of miscarriage. HPV on its own makes it more difficult, or even impossible, for an embryo to implant in the uterus due to the aftereffects of surgical treatments, including the removal of the cervix or the entire uterus, or local radiation therapy—all of which are necessary to treat the most severe manifestations of the virus”, explains Dr. Javier Martínez Guisasola, Director of IVI Burgos.

In case of a concurrent STI with the virus, this can lead to tubal factor infertility due to blockage of the fallopian tubes. With this damage to the tubes, eggs cannot be transported from the ovaries, and as a result, there will be no egg for the sperm to fertilize and thus form an embryo.

Additionally, pregnant women who are infected can transmit the infection to the newborn through the birth canal, which may lead to persistent respiratory infection (oropharyngeal papillomatosis), an event that is very unlikely but not impossible.

What are the consequences for men?

Recent European figures published in The Lancet indicate that 31% of sexually active men carry this virus, and 21% are infected with a high-risk HPV strain. Furthermore, just as women are at higher risk of developing cervical cancer, men can develop other types of cancers such as penile, foreskin, anal, and throat cancers, also associated with serotypes 16 and 18 of this viral disease.

In terms of how HPV affects male fertility, this STI causes reduced sperm motility, making it more difficult for sperm to move freely, which directly impacts the chances of achieving pregnancy. Additionally, it can affect semen quality or cause DNA fragmentation. This situation becomes more complicated when the female partner has also experienced an infection of this type, as the likelihood of encountering significant difficulties in conceiving multiplies.

Regarding prevention, “considering that HPV can be transmitted orally, vaginally, or anally, and although condom use is always recommended to prevent various STIs, including HPV, there are cases of HPV infection even with condom use. Therefore, the most effective method today is the HPV vaccine for both sexes. Women have an advantage in early detection through testing to determine the presence or absence of HPV and its serotypes, as established in the national cervical cancer screening program, or, as was done until a few years ago, through a Pap smear to detect any suspicious cellular changes and identify which HPV genotype or strain is present, allowing for appropriate therapeutic measures to be taken to prevent it from directly impacting fertility or the ability to carry a pregnancy to term without complications ”, concludes Dr. Martínez Guisasola.