JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):133
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263768

P-121. Human Papillomavirus (HPV) Infection and Infertility

Marta Ribeiro Hentschke¹, Eduarda Saldanha Silva², Giovanna Vissoky Cé²

¹ Fertilitat Centro de Medicina Reprodutiva – Porto Alegre - RS – Brasil
² PUCRS- Pontifícia Universidade Católica do Rio Grande do Sul – Porto Alegre - RS – Brasil

Objective: Explore the possible association between Human Papillomavirus (HPV) infection and infertility in both men and women. The study focused on evaluating scientific evidence that associates HPV with reduced reproductive capacity, examining proposed pathophysiological mechanisms, and considering the role of HPV vaccination in protecting fertility. Given the high global prevalence of HPV and the increasing incidence of infertility, understanding the potential intersection between these conditions is relevant for advancing reproductive health strategies.
Methods: Integrative review conducted using the PubMed database, applying a systematic search with the MeSH terms "Papillomavirus, Human" and "Infertility," combined with the Boolean operator AND. Studies published in the last ten years were selected, including original articles and reviews that addressed the impact of HPV on male or female fertility. Exclusion criteria included case reports, editorials, and studies lacking full-text access.
Results: Growing evidence that HPV may contribute to infertility through various mechanisms was observed. In men, studies have detected HPV DNA in semen samples from asymptomatic individuals. The presence of the virus in semen has been associated with decreased sperm motility, abnormal morphology, and increased DNA fragmentation, factors that can directly impair fertilization. Moreover, the virus can adhere to the sperm membrane, potentially interfering with the ability of sperm to fertilize an oocyte. In women, HPV is classically linked to cervical alterations and cancer, but its impact on fertility has gained attention in recent years. The infection may cause chronic inflammatory changes in the reproductive tract, particularly the cervix and endometrium, which could lead to impaired embryo implantation and increased risk of miscarriage. Studies involving assisted reproductive technologies, such as in vitro fertilization (IVF), have reported lower implantation and clinical pregnancy rates in women with detectable HPV in the cervix or endometrium. However, these findings remain controversial and are not yet universally accepted. One population-based study showed that HPV-positive women had a 39% higher risk of infertility compared to uninfected women. Despite these findings, there are still no formal recommendations for HPV screening or treatment in the context of infertility, underscoring the need for further research to define clinical protocols. An important aspect highlighted by the review is the possible protective role of HPV vaccination in reproductive health. While the primary goal of vaccination is to prevent HPV-related cancers, emerging evidence suggests additional benefits. Studies have shown improved sperm motility and increased pregnancy rates in couples where the male partner had previously tested positive for HPV but received the vaccine. This suggests that vaccination may help reverse some of the reproductive impairments associated with the virus.
Conclusion: Although further investigation is needed to solidify causal links, current evidence suggests that HPV infection may play a role in both male and female infertility. The virus appears to negatively affect sperm parameters and may alter the uterine environment, thereby reducing the likelihood of conception. These findings reinforce the importance of HPV prevention strategies, including vaccination, as not only a public health tool against cancer but also a potential measure to protect fertility. Integrating HPV-related concerns into reproductive health discussions could enhance fertility preservation efforts and inform future clinical practice.