Human papillomavirus and reproductive health: Current evidence on fertility, pregnancy outcomes, and vaccination safety
DOI:
https://doi.org/10.37800/RM.3.2026.632Keywords:
human papillomavirus (HPV), fertility, infertility, assisted reproductive technologies (ART), in-vitro fertilization (IVF), IntraCytoplasmic Sperm Injection (ICSI)Abstract
Relevance: Human papillomavirus (HPV) is the name of a group of 200 known viruses. They are not a concern for most people, but infection with certain high-risk virus types is quite common and can lead to anogenital warts or cancer. In addition to the established oncogenic role, HPV can adversely affect the reproductive health of men and women. However, the available data are heterogeneous and do not allow the authors to establish a causal relationship for most reproductive outcomes.
The study aimed to systematize and critically evaluate current data on the association of HPV infection with male and female fertility, ART results, pregnancy outcomes, mother–to-child transmission of the virus, and the safety of HPV vaccination.
Materials and Methods: A systematic search of publications in the PubMed/MEDLINE, Scopus, Web of Science, Embase, and Google Scholar databases was performed in accordance with the recommendations of PRISMA 2020. The review includes publications on the effects of HPV on reproductive health. After removing duplicates, screening, and evaluating full-text articles, 42 publications were included in the qualitative analysis, including systematic reviews, meta-analyses, cohort studies, and case-control studies.
Results: The most convincing data concerned male fertility. HPV infection is associated with decreased progressive motility of spermatozoa, increased DNA fragmentation, and deterioration in sperm functional characteristics. For female fertility, the evidence base remains less uniform, but infection may affect endometrial receptivity and implantation. Published studies indicate a possible association of HPV infection with a decrease in the effectiveness of certain ART programs and unfavorable pregnancy outcomes. Vertical transmission of the virus through antenatal, intranatal, and postnatal routes has been confirmed. Modern studies have not revealed any negative effects of HPV vaccination on fertility, ovarian function, pregnancy, and offspring health.
Conclusion: HPV infection can be associated with various aspects of reproductive health, but the degree of evidence of the identified associations remains variable. The most convincing evidence base has been formed for male fertility. HPV vaccination has a strong safety profile and remains the most effective way to prevent HPV-associated diseases.
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