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Many couples struggling to conceive are unaware that the human papillomavirus (HPV) could be a contributing factor. Did you know that the world’s most common sexually transmitted infection (STI) may impact fertility? Understanding the link between HPV and reproductive health is essential for making informed decisions and protecting your chances of starting a family.
What is HPV?
HPV is a group of more than 150 related viruses from the Papillomavirus genus that infect the skin and mucous membranes, potentially causing both benign tumours (warts) and malignant tumours. Depending on their oncogenic potential, HPV strains are classified into low-risk and high-risk genotypes. Genotypes 16 and 18 are the most commonly linked to the development of genital cancer.
HPV is the most prevalent sexually transmitted infection (STI) worldwide. It is estimated that approximately 75% of sexually active individuals will contract HPV at some point in their lives, particularly between the ages of 15 and 25.
According to Spain’s Ministry of Health, the average prevalence of HPV infection among women is 14.3%, rising to 29% among young women aged 18–25. High-risk genotype 16 and low-risk genotypes 6 and 11 are the most frequently detected in Spain.
The virus spreads primarily through sexual contact, including vaginal, anal, and oral sex. Transmission can occur even without ejaculation or penetration—direct skin-to-skin contact involving the vulva, vagina, penis, anus, or mouth is sufficient for infection.
In most cases, the immune system clears the virus naturally within one to two years. However, in some instances, HPV infections persist and may lead to complications such as genital warts or various cancers, including cervical, anal, oropharyngeal, vaginal, vulvar, and penile cancers.
Beyond these health concerns, HPV can also have implications for fertility.
HPV and Fertility
The exact relationship between HPV and fertility is still not fully understood, but several factors have been identified as potential risks.
HPV and Female Fertility
Any infection, including HPV, can make it more challenging for a woman to conceive. The following factors may contribute to infertility:
- Cervical Dysplasia: Cellular changes and high-grade cervical lesions caused by HPV may require medical interventions that affect the cervix. Procedures such as cervical conisation can impact fertility and increase the risk of cervical incompetence and preterm birth if the surgery is extensive.
- Cervical Cancer: Persistent HPV infections with high-risk strains can lead to precancerous changes in the cervix. If left untreated, these may develop into cervical cancer, requiring treatments like conisation or hysterectomy, which can severely affect reproductive potential.
- Chronic Infections: Persistent HPV infections can cause chronic inflammation and scarring in the reproductive tract, disrupting the balance necessary for conception.
HPV and Male Fertility
HPV infections in men are also common and may impact fertility in several ways:
- Reduced Semen Quality: Some studies suggest a link between HPV infection and decreased semen quality. One of the most significant effects is sperm DNA fragmentation, which compromises the genetic stability of the sperm.
- Implantation Failure: Infected sperm may transfer the virus to the egg during fertilisation, potentially leading to embryonic cell abnormalities. This can impair embryo development and increase the risk of miscarriage.
- Malignant Conditions in the Reproductive Tract: HPV can also cause precancerous and cancerous lesions, such as penile cancer, affecting overall reproductive health.
HPV and Assisted Reproductive Treatments
HPV can complicate assisted reproductive treatments, as the virus may affect egg and sperm quality and alter the uterine environment, potentially hindering embryo implantation.
Given this, many couples wonder whether they should proceed with fertility treatment while one or both partners have HPV or wait until the virus has cleared.
HPV is not a contraindication for pregnancy or assisted reproductive technologies (ART), provided that the virus has not caused cervical, vaginal, or external genital lesions.
At Clínica Tambre, all women undergoing fertility treatment are required to have a Pap smear beforehand. If any lesions are detected, treatment must be postponed until they are resolved. However, if HPV is present but the Pap smear is clear and no lesions are found, the treatment can proceed as planned.
In summary, in vitro fertilisation (IVF) is possible even if one partner carries HPV. Otherwise, couples would need to wait approximately 2–3 years for the virus to clear naturally, which could negatively impact fertility due to age-related decline rather than the virus itself.
Additionally, HPV infections in semen may be temporary. Since HPV replicates in actively dividing cells, such as those involved in sperm production, and the sperm development cycle lasts around two months, normal sperm quality may be restored within 3–6 months.
Prevention and early detection
A nurse place a band-aid before vaccinating a teenager.
Although there are treatments for HPV, prevention and early detection are key to avoiding fertility-related complications.
Regular screening, including HPV testing and cervical cytology (Pap smears), helps identify the virus and any associated cellular changes early on. Prompt treatment of precancerous lesions can prevent cervical cancer and reduce the need for more invasive procedures, thereby preserving fertility.
The HPV vaccine is highly effective in preventing infection with high-risk strains. It is recommended for both boys and girls before they become sexually active, although it can still be administered at any age—even after sexual activity has begun or if HPV lesions are already present. However, as the vaccine does not protect against all HPV types, regular cervical screening remains essential, even for vaccinated individuals.
What to do If you are trying to conceive with an HPV diagnosis
At Clínica Tambre, we understand that an HPV diagnosis can create uncertainty, especially when you are trying to conceive. That is why, during your first visit, we conduct a comprehensive fertility assessment to evaluate all factors that may be affecting your ability to become pregnant. Our highly specialised medical team will carefully analyse your individual case and create a personalised treatment plan to maximise your chances of success, even with an HPV diagnosis. Additionally, we will provide both medical and emotional support throughout your journey.
If you have any questions or would like more information about HPV and fertility, please contact us at +44 (0) 20 38 688 650 to schedule your initial consultation. Our expert team will guide you through the process and offer a personalised diagnosis and treatment plan.
