The human papillomavirus (HPV) is one of the most common sexually transmitted infections, affecting millions of women worldwide. While HPV is primarily known for its link to cervical cancer and genital warts, there is often confusion about its impact on fertility. Myths surrounding HPV and fertility can create unnecessary anxiety and misinformation for women who may be trying to conceive. In this article, we’ll debunk common myths and provide clarity on the relationship between HPV and fertility.
Understanding HPV: What Is It?
HPV is a group of over 200 related viruses, some of which are considered high-risk for causing cancer, while others cause non-cancerous conditions like genital warts. Of these, about 14 strains are considered high-risk for leading to cervical and other cancers. Most HPV infections are asymptomatic and are naturally cleared by the body within two years. However, persistent infection with high-risk strains can lead to the development of precancerous lesions and, if left untreated, cervical cancer.
Myth 1: HPV Causes Infertility
Reality: HPV Alone Does Not Directly Affect Fertility
One of the most prevalent myths is that HPV infection directly causes infertility in women. There is no direct evidence that HPV itself reduces a woman’s ability to conceive. Most women with HPV are able to become pregnant naturally and have healthy pregnancies.
However, HPV-related complications, such as cervical abnormalities or treatments for severe cervical dysplasia, can indirectly affect fertility. For example:
- Women who undergo repeated cervical procedures, such as a LEEP (Loop Electrosurgical Excision Procedure) or cone biopsy, to remove precancerous cells may experience changes to the cervix. This can potentially impact fertility by affecting the cervix’s ability to produce mucus needed for sperm movement or by leading to cervical shortening.
While these procedures may pose minor risks, they are typically necessary to prevent the progression of cervical cancer and are not likely to cause infertility in most women.
Myth 2: HPV Vaccines Cause Infertility
Reality: HPV Vaccines Protect Against Cancer and Do Not Impact Fertility
Another common myth is that the HPV vaccine, such as Gardasil 9, can cause infertility. This misconception has been perpetuated by misinformation, but there is no scientific evidence to support the claim that HPV vaccination affects fertility.
In fact, the HPV vaccine is designed to prevent the types of HPV that lead to cervical cancer and genital warts, protecting women from needing more invasive treatments later in life. By reducing the risk of cancer, the vaccine indirectly protects fertility, as women are less likely to require procedures that might affect their reproductive health.
The CDC, World Health Organization (WHO), and numerous studies confirm that the vaccine is safe and effective, with no negative effects on fertility.
Myth 3: HPV Will Affect Your Pregnancy
Reality: Most Women with HPV Have Healthy Pregnancies
HPV itself rarely impacts pregnancy. Women with HPV can typically conceive without difficulty, and the virus does not usually affect the health of the pregnancy. However, there are a few considerations to be aware of:
- HPV-related genital warts may grow faster during pregnancy due to changes in hormone levels and blood flow, but this is a manageable condition that does not harm the baby.
- Cervical cancer screening remains important during pregnancy. If a woman has abnormal Pap test results during pregnancy, she can still be monitored or treated safely, depending on the severity.
Most pregnant women with HPV will not require any special treatment, and the virus does not usually interfere with the pregnancy or pose a risk to the baby. In rare cases, a mother may pass the virus to her baby during vaginal delivery, potentially causing recurrent respiratory papillomatosis (RRP), a condition where warts grow in the baby’s airways. However, this is extremely uncommon.
Myth 4: You Can't Get Pregnant After Treatment for Cervical Dysplasia or Cervical Cancer
Reality: Fertility After Cervical Procedures Is Often Preserved
Some women with high-risk HPV may develop cervical dysplasia, or precancerous changes in the cells of the cervix. When caught early, these abnormal cells can often be treated without affecting a woman’s fertility. Common procedures include:
- Cryotherapy: Freezing off abnormal cells.
- LEEP: Removing abnormal tissue using an electrical current.
- Cone biopsy: Removing a cone-shaped piece of tissue from the cervix for examination or treatment.
While these treatments aim to preserve the cervix as much as possible, more aggressive interventions may be needed in the case of advanced cervical cancer. Even then, many women retain the ability to get pregnant. Fertility preservation options, such as egg freezing, are also available for women who need more extensive treatment, such as a hysterectomy or radiation therapy.
HPV, Cervical Health, and Fertility: What You Should Do
While HPV itself does not directly cause infertility, keeping track of your cervical health is key to preventing future complications. Here are some steps to take:
Regular Pap Smears and HPV Testing: Regular cervical cancer screening through Pap smears and HPV tests can detect early abnormalities, helping you stay on top of your reproductive health. Women between the ages of 21 and 65 are recommended to undergo these screenings regularly.
Get Vaccinated: If you haven’t already, the HPV vaccine is an excellent preventive measure that can reduce the risk of cervical cancer. It is recommended for girls and boys starting at age 11-12 and is approved for use up to age 45.
Consult Your Doctor: If you have been diagnosed with cervical dysplasia or cervical cancer, work with your doctor to discuss the best treatment options that will preserve your fertility, such as less invasive procedures or fertility preservation options.
Monitor During Pregnancy: If you’re pregnant and have HPV, ensure your healthcare provider knows. Routine screening and monitoring are usually all that is required.