HPV and Fertility*

Introduction

Around 80 million Americans have at least one type of human papillomavirus (HPV).¹ If you are someone with HPV and would like to get pregnant, learn more about this condition and how it might affect your fertility.

What Is the Human Papillomavirus?

HPV is actually a group of around 200 different but related viruses that transmit via skin-to-skin contact. The virus infects surface cells on the oral or genital mucous membranes as well as parts of the skin, such as the hands or feet, and can cause warts to grow. Some strains of the virus are at high risk for cancer.

It is the most common sexually transmitted infection², but HPV can be transmitted in other ways. At some point in their lives, up to 80 percent of the population will contract the virus, many without even knowing it.³

How Does HPV or Its Treatment Affect Fertility?

HPV might be a risk factor for infertility, but it is not an independent cause. HPV generally should not interfere with a couple’s ability to conceive, since the infection does not affect fertility directly. However, some HPV strains increase a woman’s risk of cervical cancer. The removal of the cancerous or precancerous cells from the cervix can impact fertility in some cases.⁴ If cells need to be removed, one of the following procedures would be used:

• cryotherapy, which freezes and eliminates the abnormal tissue
• cone biopsy, which removes part of the cervix
• loop electrosurgical excision procedure (LEEP) to remove abnormal cells with a wire loop that uses an electrical charge

Because cell removal can alter cervical mucus production, these procedures might affect fertility. These procedures also could cause a narrowing of the opening of the cervix, or stenosis. This narrowing could cause sperm to move slower and make fertilizing an egg more difficult.

Some types of HPV might affect sperm quality and motility, which could then lead to problems conceiving.

What Causes HPV?

HPV infection is primarily transferred by skin-to-skin contact when the virus enters the body, usually through a cut, small tear, or abrasion in the skin. Genital HPV infections happen through sexual intercourse, including anal and oral sex, or other skin-to-skin contact in the genitals. A mother with genital warts can pass the infection to her baby during birth.

Warts are contagious and can be spread through direct contact or when someone touches something that was in contact with a wart.

Symptoms and Treatment for HPV

Most people who have HPV do not have any noticeable symptoms. For most, HPV causes no health problems. Around 90 percent of HPV cases clear up on their own within two years, without any treatment.⁵

HPV types that are high-risk for cancer do not elicit any symptoms. The only indication of HPV infection is found during a Pap smear that shows abnormal cells in the cervix. High-risk HPV in other areas of the body will have no symptoms unless cancer develops, years later.

Warts might appear as a result of some HPV types.⁶

• Genital warts: Two types of low-risk HPV, types 6 and 11, cause most genital warts.⁷ They appear mostly on the vulva in women, but warts can also appear near the anus, in the vagina, or on the cervix. Genital warts look like flat lesions, small cauliflower-like bumps, or tiny stem-like protrusions. These warts usually cause no pain or discomfort.
• Common warts: These warts usually appear on the hands and fingers, and they look like rough, raised bumps. Most of the time, common warts are simply unpleasant to look at, though sometimes they can be painful or susceptible to injury or bleeding.
• Plantar warts: Plantar warts, hard, grainy growths, might cause some discomfort. They usually occur on the heels or balls of the feet.
• Flat warts: These flat-topped, slightly raised lesions can appear anywhere. Children tend to get flat warts on the face, men usually get the warts in their beard area, and women are more likely to get them on their legs.
• HPV has no cure. The problems that result from HPV infection can be treated, though. Warts can be removed, and cancer can be treated if it develops. Doctors can remove precancerous cells from the cervix.

How Does HPV Affect Pregnancy?

Certain treatments for removing precancerous or otherwise abnormal cells from the cervix might cause the cervix to weaken and lead to cervical insufficiency. This could affect your ability to carry a baby to full term.

If you are concerned about HPV and its effects on fertility, then speak with your healthcare provider. With or without an HPV infection, your chances of conception are likely to be better when your overall, emotional, and reproductive health are optimal.