title: Human Papillomavirus Infection, Infertility, and Assisted Reproductive Outcomes.
abstract: The human papillomavirus (HPV) is a sexually transmitted infection common among men and women across all geographic and socioeconomic subgroups worldwide. Recent evidence suggests that HPV infection may affect fertility and alter the efficacy of assisted reproductive technologies. In men, HPV infection can affect sperm parameters, specifically motility. HPV-infected sperm can transmit viral DNA to oocytes, which may be expressed in the developing blastocyst. HPV can increase trophoblastic apoptosis and reduce the endometrial implantation of trophoblastic cells, thus increasing the theoretical risk of miscarriage. Vertical transmission of HPV during pregnancy may be involved in the pathophysiology of preterm rupture of membranes and spontaneous preterm birth. In patients undergoing intrauterine insemination for idiopathic infertility, HPV infection confers a lower pregnancy rate. In contrast, the evidence regarding any detrimental impact of HPV infection on IVF outcomes is inconclusive. It has been suggested that vaccination could potentially counter HPV-related sperm impairment, trophoblastic apoptosis, and spontaneous miscarriages; however, these conclusions are based on in vitro studies rather than large-scale epidemiological studies. Improvement in the understanding of HPV sperm infection mechanisms and HPV transmission into the oocyte and developing blastocyst may help explain idiopathic causes of infertility and miscarriage.
authors.affiliation: The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, NY 10021, USA.
authors.forename: Nigel
authors.initials: N
authors.lastname: Pereira
authors.affiliation: The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, NY 10021, USA.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Kucharczyk
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY 10021, USA.
authors.forename: Jaclyn L
authors.initials: JL
authors.lastname: Estes
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY 10021, USA.
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Gerber
authors.affiliation: The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, NY 10021, USA.
authors.forename: Jovana P
authors.initials: JP
authors.lastname: Lekovich
authors.affiliation: The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, NY 10021, USA.
authors.forename: Rony T
authors.initials: RT
authors.lastname: Elias
authors.affiliation: The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, NY 10021, USA.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Spandorfer