title: Human Papillomavirus Positivity in Women Undergoing Intrauterine Insemination Has a Negative Effect on Pregnancy Rates.
abstract: BACKGROUND
  Sexually transmitted infections are a major cause of infertility. Human papillomavirus (HPV) infection is one of the most common viral infections of the female genital tract. Only a limited number of studies have investigated the influence of HPV on fertility and its impact remains controversial.
  
  
  OBJECTIVE
  We investigated the relationship between cervical HPV infection and pregnancy outcome after intrauterine insemination (IUI). Since other sexually transmitted infections could also influence outcome, we also analyzed the influence of Trichomonas vaginalis (TV) and Chlamydia trachomatis (CT) on pregnancy outcome.
  
  
  METHODS
  We performed a retrospective analysis of 590 women who underwent 1,529 IUI cycles at AML between 2010 and 2014. Positivity of 18 different HPV types (6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 67, 68) and TV was assessed by PCR in cervical cytology specimens. CT status was ascertained by detection of IgA/IgG antibodies on serum samples or by PCR on cervical swabs.
  
  
  RESULTS
  The HPV prevalence per IUI cycle was 11.0 and 6.9% for CT; none of the women tested positive for TV. HPV-positive women were six times less likely to become pregnant after IUI (1.87 vs. 11.36%; p = 0.0041). There was no significant difference in pregnancy rates between women with or without a history of CT (8.51 vs. 11.10%; p > 0.05).
  
  
  CONCLUSIONS
  Detection of HPV is associated with a negative IUI outcome.
authors.affiliation: Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, Antwerp, Belgium.
authors.forename: Christophe E
authors.initials: CE
authors.lastname: Depuydt
authors.forename: Ludo
authors.initials: L
authors.lastname: Verstraete
authors.forename: Mario
authors.initials: M
authors.lastname: Berth
authors.forename: Johan
authors.initials: J
authors.lastname: Beert
authors.forename: John-Paul
authors.initials: JP
authors.lastname: Bogers
authors.forename: Geert
authors.initials: G
authors.lastname: Salembier
authors.forename: Annie J
authors.initials: AJ
authors.lastname: Vereecken
authors.forename: Eugene
authors.initials: E
authors.lastname: Bosmans
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007315:Insemination, Artificial / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D030361:Papillomavirus Infections / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D014245:Trichomonas Infections / Q000453:epidemiology*