Increased Risk of Infertility in Women Infected with Human Papillomavirus

Parastou Heidari Pebdeni; Fereshteh Saffari; Hamid Reza Mollaei; Toraj Reza Mirshekari; Robabeh Hosseini Sadat; Victoria Habibzadeh; Lida Saeed; Moslem Taheri Soodejani; Roya Ahmadrajabi

doi:10.18502/jri.v24i3.13275

Increased Risk of Infertility in Women Infected with Human Papillomavirus

J Reprod Infertil. 2023 Jul-Sep;24(3):188-197. doi: 10.18502/jri.v24i3.13275.

Authors

Parastou Heidari Pebdeni¹, Fereshteh Saffari², Hamid Reza Mollaei², Toraj Reza Mirshekari³, Robabeh Hosseini Sadat⁴, Victoria Habibzadeh⁴, Lida Saeed⁴, Moslem Taheri Soodejani⁵, Roya Ahmadrajabi⁶

Affiliations

¹ Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran.
² Department of Medical Microbiology (Bacteriology & Virology), Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
³ Afzalipour Clinical Center for Infertility, Kerman University of Medical Sciences, Kerman, Iran.
⁴ Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
⁵ Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
⁶ Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Abstract

Background: Among several causes of infertility, urogenital infections seem to be influencing factors. The effect of bacterial or viral sexually transmitted infections (STIs) on human fertility is not well understood. The aim of this study was to determine the frequency of STIs in cervical samples of infertile and fertile women and study the relationship between these agents and infertility.

Methods: In this case-control study, cytobrush was used for collecting of cervical sample from each infertile and fertile woman (n=95) who attended Research and Clinical Centers for Infertility in Kerman, Iran. PCR and real-time PCR methods were used to detect the presence of bacterial (genital Ureaplasma species, genital Mycoplasma species, Chlamydia trachomatis (C. trachomatis), and Gardnerella vaginalis) and viral (herpes simplex virus, human papillomavirus (HPV), and Epstein-Barr virus) agents, respectively. Fisher's exact test and the logistic regression with the significance level of ≤5% were used for statistical analyses.

Results: In general, 78.94% and 14.73% of specimens were positive for one or more studied microorganisms, respectively. Among studied agents, only the infection with HPV was significantly different between infertile and fertile groups (p=0.005) which may enhance the likelihood of female infertility (OR=5.30, 95% CI:1.47-19.11, p< 0.05). After adjusting for age, irregular menstrual cycle, abnormal vaginal discharge, and ectopic pregnancy, the odds ratio of infertility in HPV-infected women increased (OR=7.02, 95% CI:1.52-32.3, p<0.05).

Conclusion: Since HPV infection is asymptomatic, periodic screening of women in reproductive age especially infertile couples is recommended for early diagnosis and prevention of infection progression and cross contamination.

Keywords: Female; Infertility; Iran; Sexually transmitted infections.