Does HPV affect fertility and pregnancy?

Reviewed by our clinical team

The human papillomavirus, or HPV, is a virus that only affects humans. There are over 100 different types (or strains) of HPV. Most are harmless and don’t cause symptoms – in fact, your body will probably clear the virus without you ever knowing you were infected. However, a small number of HPV strains are considered “high-risk” because they can lead to cell changes that can cause certain cancers. Other types cause verrucas, or warts whilst others cause genital warts. High-risk HPV as well as "genital warts" HPV can be passed on during vaginal, anal, or oral sex, when using sex toys, or simply through intimate touching.

Genital warts caused by (low risk) HPV usually have no impact on your fertility, pregnancy or birth of your baby.

If you have high risk HPV, "pre-cancer" (CIN) or cervical cancer, there could be some issues around getting pregnant and carrying the baby right through to the end.

HPV and fertility

Does HPV affect female fertility?

Having genital warts does not reduce your chances of getting pregnant, unless the warts are so big that they block off the entrance to your vagina. There are some studies that seem to show that having HPV (either genital warts or high-risk HPV) might cause early miscarriage, but this is not certain.

If you have pre-cancer (CIN) or cervical cancer the treatment for this can make conceiving and carrying a pregnancy more difficult. One treatment option for CIN (pre-cancer) and very low-grade cervical cancer would be to remove a part of the cervix: the so-called "cone biopsy". This can stop the womb from staying tightly shut until delivery - causing a miscarriage.

If your cancer is more advanced, you might have slightly more extensive surgery: the whole cervix and a small part of the upper part vagina would be removed. This is a radical trachelectomy, also known as RT. Even after this operation it is still possible to conceive and have a successful pregnancy.

More advanced cervical cancer is usually treated with the removal of your womb -a hysterectomy. Radiotherapy or chemotherapy can also affect your womb and/or your ovaries so a pregnancy is usually not possible afterwards.

In a nutshell: the earlier you are diagnosed and treated the better your chances of having a normal pregnancy – this is why it’s really important to attend your scheduled cervical screenings, and to see your GP if you notice any worrying symptoms. You can learn more at the Cancer Research UK website.

Does HPV affect male fertility?

The short answer is we don't know for sure. Some studies have shown that sperm infected with HPV moves less well - they have reduced motility. This can make it more difficult to conceive. However, this view is not widely accepted because other studies have not found a link. 

In rare cases, high-risk HPV can cause cell changes that increase your risk of certain cancers, including cancer of the penis. For men, some cancer treatments might affect fertility. You can learn more at the Macmillan Cancer Support website.

HPV and pregnancy

Is HPV passed on to the baby during pregnancy or birth? 

If you have genital warts when you give birth, there’s a small risk of passing the virus onto your baby. Rarely, babies born to mothers with genital warts will develop an infection in their throat or genitals.

Does HPV mean a high-risk pregnancy?

Having genital warts does not mean your pregnancy is considered to be high risk, but you should tell your midwife and / or GP about it.

During pregnancy it’s possible for genital warts to grow and multiply, and in some cases get so big they cause problems during the birth. While it’s possible to get treatment for genital warts during pregnancy, some treatments may need to be avoided because they won’t be safe.

Despite the term "high risk HPV", having this during pregnancy does not make your pregnancy high risk. Overall pregnancy rates and outcomes are thought to be similar for women with and without high-risk HPV. Research is ongoing and there have been a few studies looking at this. Some have found a possible link to some pregnancy complications: for example, early miscarriage.

In contrast to this, some studies have found that HPV is cleared during the later stages of pregnancy/after birth.

If you had treatment for pre-cancer (CIN) or cervical cancer and you are thinking about getting pregnant your gynaecologist will advise you on what to expect, depending on what treatment you have had (see above).  If you are diagnosed with pre-cancer (CIN) or cervical cancer during pregnancy, read this guide from Cancer Research UK to learn more.

How to stay safe

It’s not always easy to avoid infection with HPV because it’s spread via skin-to-skin contact. In general, though, it’s a good idea to always use condoms and dental dams during sex with any new or casual partners, and to avoid sex if you notice any symptoms like lumps or growths around the genitals.

You can also protect yourself by getting regular STI tests and – if you’re a woman – attending your scheduled cervical screenings. Cervical screenings will look for high-risk strains of HPV to find out if you have an increased risk of cell changes that might lead to cancer. Screenings can help you get early diagnosis and effective treatment.

Unfortunately, there’s no routine screening programme for high risk HPV available for men, which is why it’s important to see your GP if you notice any new symptoms that might point to cancer.

If you’re very concerned about HPV, consider getting the vaccine, as this will protect you against most of the high-risk strains, as well as those which commonly cause genital warts.

Get the HPV vaccine from Online Doctor

You’ll be eligible for the HPV vaccine on the NHS if you were offered it in school in the UK, but missed out – provided you are younger than 25. You’ll also be eligible if you’re a man who has sex with men, and you’re under the age of 45.

If you can’t get the vaccine for free on the NHS, you can order the HPV vaccine through Online Doctor, and receive your injections in your nearest LloydsPharmacy store.

References

https://www.nhs.uk/conditions/human-papilloma-virus-hpv/
https://www.nhs.uk/conditions/genital-warts/
https://rbej.biomedcentral.com/articles/10.1186/s12958-020-00604-0
https://www.tommys.org/research/research-topics/premature-birth-research/hpv-infection
https://www.researchgate.net/publication/11290604_High-risk_human_papillomavirus_clearance_in_pregnant_women_Trends_for_lower_clearance_during_pregnancy_with_a_catch-up_postpartum