Can HPV cause infertility?

HPV is a sexually transmitted infection that usually resolves itself in a few years. But men and women with HPV can experience fertility-related side effects, including trouble getting and staying pregnant. HPV treatments can also make it harder to conceive, so here's what to know if you're thinking of trying to get pregnant. 

What is HPV?

HPV (human papilloma virus) is the most common sexually transmitted infection, affecting as many as 75 percent of American women and men of reproductive age. More than a hundred types or strains of the virus exist, and they can cause very different symptoms. HPV is spread through the skin-to-skin contact that happens during vaginal, anal, and oral intercourse.

Many of the HPV strains cause warts in the vaginal area and cervix (the opening to the uterus). Often these warts are too small to see, and they're generally harmless. But a few strains of the virus are more worrisome because they can actually damage the cells of the cervix and turn them cancerous.

Can you get pregnant with HPV?

HPV is often not mentioned as a primary or common cause of infertility, but many sexually transmitted infections can make it harder to get pregnant, and that may include HPV. This can happen when a man or a woman has an HPV infection.

That said, most HPV infections clear up on their own within two years without causing any other health problems. So does HPV cause infertility or not?

There isn't quite enough research to say, but we do know that for women, HPV increases your risk of developing precancerous or cancerous cells in your cervix, which could affect both your fertility and your ability to carry a baby to term.

For men, HPV can have a negative effect on sperm quality and fertility outcomes, with one study suggesting that men with abnormal sperm quality were more likely to have an HPV infection and another finding that HPV detection in sperm was associated with a higher incidence of miscarriage. While HPV won't automatically make you sterile, some researchers have found a connection between HPV infections and male infertility.

HPV treatment options

Precancerous changes in the cervix can be mild to severe. In general, mild changes (called low-grade dysplasia) may not necessarily require treatment – just close follow-up care from your gynecologist.

If you do need treatment to remove precancerous cells before they progress to the cancerous stage, your doctor will probably use one of three techniques: removing a portion of the cervix (a cone biopsy); freezing and destroying abnormal tissue (cryosurgery), or removing cells via an electrically charged wire loop, called LEEP (loop electrosurgical excision procedure).

Fortunately, cervical cancer is very treatable when caught early.

Will HPV treatment affect my chances of getting pregnant?

Unfortunately, some of these procedures may make it more difficult for you to get pregnant or to carry a baby to term. Cervical cell removal can sometimes affect the production of cervical mucus. Healthy, normal mucus helps sperm swim up into the reproductive tract. Without it, sperm can have a hard time reaching the egg.

Depending on how much tissue is removed, the treatment may also weaken the cervix, leading to a condition known as cervical insufficiency. This can make you more likely to miscarry because your cervix may open during pregnancy.

If you're trying to conceive, minimizing the amount of tissue removed will reduce any effect on a future pregnancy, but it's vitally important for your doctor to take out all of the abnormal cells. If precancerous cells remain untreated and develop into cervical cancer, there's a chance you'll need a hysterectomy (removal of the uterus), which would rule out any future pregnancies.

Talk to your doctor about your future pregnancy concerns. If you're not comfortable with the answers, seek a second opinion. There may be more than one medically reasonable way to approach your situation. In general, the recommendations for treatment are getting more conservative as we learn more about HPV and cervical pre-cancer and cancer. There also may be some other strategies used, such as freezing eggs or ovarian tissues, to preserve fertility when treatment is needed.

Risks of having HPV

The main risk of having HPV is the risk of cancer. Not only can HPV cause cervical cancer, it's associated with higher risks of other types of cancers, too.

It's important to remember, though, that you can also pass the HPV virus to your partner during sexual intercourse or even through close sexual contact with the affected area. (If you've been having unprotected sex, they're probably already infected.)

If you have active HPV warts during your pregnancy, there's also a very slim chance that your baby will come into contact with the virus while passing through the birth canal and develop warts on the larynx (vocal cords).

How to prevent HPV

Unfortunately, there's no cure for HPV, but there is an HPV vaccine that protects women (and men) against the strains most likely to lead to cancer. Three doses of the vaccine are recommended for girls and boys at age 11 or 12. You can also reduce your chances of contracting HPV by using condoms during intercourse, but keep in mind that condoms aren't 100 percent protective against HPV.

If you get HPV, your healthcare provider can prescribe medication to treat the warts. And you can prevent the infection from progressing to cervical cancer by having yearly Pap smears and getting any precancerous cells treated quickly.