Human papillomavirus (HPV) is responsible for 99% of cervical cancers. It is also implicated in other cancers — of the vulva, vagina, penis, anus, oral cavity, and throat. The vaccine prevents 97% of precancerous lesions and genital warts linked to HPV. Its preventive effectiveness is therefore beyond doubt. However, several parents worry about its effects on their children’s fertility, after false information has spread on social media. An article in the Canal Detox column of the French National Institute of Health and Medical Research shows that not only is this fear unfounded but HPV also infection itself can threaten their children’s fertility.

Risk to Fertility

• The effect of HPV on fertility in women remains uncertain. A few studies have suggested a link between HPV infection and miscarriage; others have found no connection between the infection and reduced fertility in women.
• In men, an effect of HPV on fertility has been demonstrated:
  • A significant decrease in ejaculate volume and sperm count.
  • Asthenozoospermia (reduced sperm motility).
  • Increased sperm DNA fragmentation.
  • The appearance of antibodies against sperm.
  • In couples, these HPV effects on sperm translate into reduced fertility. One study showed that HPV infection in the male partner significantly increases the for miscarriage and reduces the likelihood of conception and of pregnancy carried to term. 

No Risk to Fertility

As a reminder, this vaccine is recommended for girls and boys aged 11-14 years, before the onset of sexual activity. Catch-up vaccination is possible up to age 26.

• In women, two studies have found no link between HPV vaccination and infertility. Authors of a Cochrane literature review covering 225 studies and 132 million vaccinated people concluded that their work demonstrated with a high degree of certainty that the HPV vaccine did not cause fertility problems.
• In men, a study was conducted among 151 infertile couples in which HPV had been detected in semen. Vaccination was offered to try to reduce the amount of virus in the semen. Almost half of the couples refused. In the vaccinated group:
  • Sperm motility improved.
  • Thirty pregnancies were achieved in the vaccinated group (39% of couples) vs11 (15%) in the control group; the difference was statistically significant.
  • There was only one miscarriage and 29 births in the vaccinated group, whereas in the unvaccinated group there were seven miscarriages and only four births. 

In conclusion, the rumor that the HPV vaccine reduces recipients’ fertility undermines vaccine uptake and thus slows progress in reducing cancers preventable by vaccination.

This story has been translated from Univadis France, part of the Medscape Professional Network.