You've probably heard of human papillomavirus (HPV) and its link to cervical cancer, but maybe you didn’t know HPV also may hamper your chances for a healthy pregnancy. Here we explain the latest research on HPV's impact on fertility and pregnancy.
What is HPV?
HPV is the name for a group of viruses that are so common that nearly everyone will get one strain of HPV at some point — although many people are symptomless and don't know they have HPV (1). The viruses are spread by genital contact with an infected partner. In most cases, HPV can resolve on its own without causing any health issues, but if it doesn’t, typical symptoms include genital warts and cervical lesions (1).
HPV is blamed for the vast majority of cases of cervical cancer, which is the fourth most common cancer among women worldwide (2), however HPV may affect fertility in both men and women. More medical research is needed to understand precisely how, but we’ll get to that.
How does HPV affect female fertility?
Right now, the science is mixed on how HPV affects your fertility. When a research team tracked 590 women who underwent 1,529 intrauterine insemination (IUI) cycles, they found that the HPV-positive women were six times less likely to conceive than HPV-negative women after IUI (3). On the other hand, a 2019 analysis of 10,595 Danish women found no link between testing positive for HPV and female infertility (4).
Scientists are trying to make sense of all this, including whether having HPV symptoms (such as cervical lesions) plays a role.
As the authors of a 2019 paper in Fertility and Sterility observed, "the prevalence of high-grade cervical lesions is twice as high in women with infertility compared with women in the general population, implying a more complex association between HPV and infertility (4)." These authors also pointed out that earlier research suggested an HPV infection might harm the trophoblast, which nourishes the embryo, or may interfere with implantation (4).
The key takeaway? More research is needed. Although the American College of Obstetricians and Gynecologists doesn't specifically list HPV as a cause of infertility, the group does note that sexually transmitted infections (and HPV is an STI) may cause scarring or blockages in the fallopian tubes that may contribute to infertility (5).
How does HPV affect male fertility?
The research linking male infertility and HPV is less murky than the science on women. When men have HPV, the virus may appear in semen and even in the sperm head, affecting sperm quality (6). When a research team studied HPV in a sample of 290 fertile and infertile men, they noted, "infertile patients had a prevalent infection on sperm (6)."
Similarly, an earlier study of 1,138 men found a higher HPV infection rate among infertile males than fertile males and suggested the infection damaged the shape of sperm and made them less motile (7).
Can HPV harm a pregnancy?
Having an HPV infection may increase your risk for a miscarriage or preterm birth, although the likelihood appears to depend on the strain of HPV (3, 8).
HPV has been detected in placental tissues and may be passed to a newborn during a vaginal delivery through an infected cervix (9). However, newborns who tested positive for HPV were found to be free of HPV infections six months after birth (9).
How can I prevent HPV?
Talk to your doctor about how to best prevent HPV based on your lifestyle. If you weren't vaccinated as an adolescent, your doctor may recommend getting the vaccine.
The CDC recommends the vaccine for women up to age 26 and men up to age 21, per recently updated guidelines (10). This may help safeguard any impacts to your fertility and protect you from 90% of HPV-related cancers (11).