The Effect of Vaccination Against Human Papillomavirus on Fecundability

Abstract

Background The human papillomavirus (HPV) vaccine was developed to prevent infection with strains of HPV that cause cervical cancer. While HPV infection has been associated with reduced semen quality and lower pregnancy rates in some, no studies have examined the relationship between HPV vaccination and fecundability. We hypothesize that HPV prevention via vaccination will protect fecundity. Methods We analyzed data from Pregnancy Study Online (PRESTO), a preconception cohort of North American pregnancy planners. Between 2013 and 2017, we followed 3,483 female pregnancy planners and 1,022 of their male partners for 12 months or until reported pregnancy, whichever came first. At baseline, participants reported whether they had been vaccinated against HPV and their age at vaccination. We estimated fecundability ratios (FR) and 95% confidence intervals (CI) using proportional probabilities models adjusted for sociodemographics, smoking, and abnormal Pap test before HPV vaccination (females only). Results HPV vaccination was more prevalent among females (33.9%) than males (5.2%). There was little overall association between female vaccination (FR=0.98, 95% CI: 0.90, 1.08) or male vaccination (FR=1.07, 95% CI: 0.79, 1.46) and fecundability. Among females with a history of sexually transmitted infections or pelvic inflammatory disease (i.e., a group at high risk of exposure to HPV infection), those vaccinated against HPV had higher fecundability than those not vaccinated (FR=1.35, 95% CI: 0.99, 1.86). Conclusion Although HPV vaccination had little effect on fecundability overall, HPV vaccination was positively associated with fecundability among women with a history of sexually transmitted infections.

<p>Prevalence and Genotype Distribution of High-Risk Human Papillomavirus Infection in Women with Abnormal Cervical Cytology: A Population-Based Study in Shanxi Province, China</p>

“…Studies have reported that women with gynecological diseases were prone to HR-HPV infection, due to unstable sexual hormone levels, poor function of the immune system, lower resistance to HR-HPV, and weakviral clearance. 33,34 Our findings indicated that HPV16 is the most frequently identified type in women with ASC-US, LSIL, and HSIL+ in Shanxi, confirming that HPV16 is the main HR-HPV type associated with cervical lesions.…”

HPV Infection and Vaccination: A Question and Answer Guide for School Nurses

“…Response. The HPV infection is linked to significant reproductive function abnormalities in women (Souho et al, 2015) and in men (McInerney et al, 2017). One study reported that women who were found to be HPV-positive were six times less likely to become pregnant after intrauterine insemination (Ambühl et al, 2016).…”

“…Similarly, another study on women who were found to have a current cervical HPV infection experienced a decline in conception when using in vitro fertilization (Garolla et al, 2018). The HPV infection also negatively affects fertility in men as it can reduce sperm motility and increase antisperm antibodies (McInerney et al, 2017). On the contrary, the HPV vaccine has no adverse effect on oocyte counts and fertilization rates (Demir et al, 2020).…”

A prospective study of treatments for cervical intraepithelial neoplasia and fecundability

“…[19][20][21] In the sole study of HPV vaccination and fecundability, a history of HPV vaccination had little effect on fecundability overall, but vaccination was associated with higher fecundability among women with a history of sexually transmitted infections (STIs). 22 Treatment for suspected CIN involves several steps. First, a colposcopy is performed to visually examine the cervix, vagina, and vulva.…”

“…The volume of tissue removed is generally greatest for conization (a procedure usually reserved for severe precancerous lesions), 23 followed by LEEP or laser cone, followed by ablative procedures (laser ablation or cryotherapy). 22 Some women with persistent or recurrent CIN2/3 may require repeat procedures, resulting in the loss of additional cervical length. Although regeneration of the cervical tissue is possible, the more tissue that is removed, the lower the likelihood of regeneration.…”