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

Parastou Heidari Pebdeni Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
Fereshteh Saffari Department of Medical Microbiology (Bacteriology & Virology), Afzalipour Faculty of Medicine, Kerman University of Medical Sci-ences, Kerman, Iran
Hamid Reza Mollaei Department of Medical Microbiology (Bacteriology & Virology), Afzalipour Faculty of Medicine, Kerman University of Medical Sci-ences, Kerman, Iran
Toraj Reza Mirshekari Afzalipour Clinical Center for Infertility, Kerman University of Medical Sciences, Kerman, Iran
Robabeh Hosseini Sadat Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
Victoria Habibzadeh Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
Lida Saeed Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
Moslem Taheri Soodejani Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi Uni-versity of Medical Sciences, Yazd, Iran
Roya Ahmadrajabi Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran

DOI: https://doi.org/10.18502/jri.v24i3.13275

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

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.