Facts about Fertility, HPV, and Cervical Cancer

HPV is a sexually transmitted illness that, if left untreated, can lead to cervical cancer. Discover facts about fertility, HPV, and cervical cancer by reading on and understanding the connections between these health issues.

Human papillomavirus, or HPV, is a sexually transmittable virus that exists in over 100 distinct forms. Approximately 40 of these variants spread through sexual contact, and 15 of them can provoke alterations in the cervix, potentially resulting in cervical cancer.

According to Bradley J. Monk, M.D., up to 75% of females will get HPV by age 50. According to studies from the University of Washington, having even a single sexual partner greatly increases your risk of developing HPV. The study revealed that within a year after having intercourse with their first partner, about 30 percent of girls tested positive for HPV.

HPV Infection Is Quite Frequent

Dr. Monk explains that HPV is mostly asymptomatic (though a few strains may cause genital warts) and that our bodies are able to fight off the infection over time readily. HPV can remain undiagnosed in the body for years without creating symptoms.

But, if the virus does not go away on its own (more likely as you age or if you have a weaker immune system), it may induce cell abnormalities in the cervix, which may result in abnormal Pap test results.

According to the Department of Health and Human Services, individuals between the ages of 35 and 60 who undergo annual Pap screenings should also receive an HPV test every five years. In addition, they emphasize that although HPV is prevalent in girls under the age of 30, it typically resolves on its own and does not necessitate annual screening.

The majority of persons with female reproductive systems discover they have HPV only after receiving abnormal Pap test results (a indication your body hasn’t successfully fought the virus). Dr. Monk explains that it is becoming increasingly typical to perform simultaneous Pap and HPV testing, so if your Pap test is abnormal, the material can be checked for HPV without requiring a second sample (and trek back to the doctor). Unfortunately, not all labs do this automatically; therefore, you should confirm with your physician’s office that yours does.

HPV and Pap Smear Abnormalities

Don’t panic if you receive abnormal Pap test results; they could indicate a variety of different conditions. First, be aware that between 5 and 10 percent of individuals who receive annual Pap tests will have abnormal results at some point. Occasionally, this is due to a difficult-to-read sample or another condition (such as a recent yeast infection) that renders the results confusing. Even having intercourse, douching, or undergoing a test during or after a woman’s period can occasionally skew results. In such instances, your physician would likely repeat the test.

If your Pap test is abnormal and you test positive for HPV, your doctor will likely do a colposcopy to determine the severity of the cervical alterations. This treatment involves examining the cervix with a telescope-like instrument and removing a tiny sample of cells for laboratory analysis. Your doctor will then better understand what kind of treatment, if any, you will require.

Luckily, an abnormal Pap test does not necessarily indicate that a woman will develop cervical cancer. Dr. Monk explains, “There is a vast continuum here, from merely obtaining HPV to developing cervical cancer, which is really rare in comparison.”

Consider the following fact to provide perspective:

• 10% of the millions of people infected with HPV will develop a persistent infection that their immune system cannot fight off.
• Only a small percentage, perhaps 1 in 100, will develop precancerous lesions (abnormal cells that could become cancer if left untreated).
• There are three fundamental levels of abnormality present in precancerous lesions. Usually, physicians will not even treat the initial, mildest level because the aberrant cells typically disappear on their own.
• Typically, if the second and third levels are treated swiftly, the anomalies will not have the opportunity to develop into a full-blown malignancy. Cervical cancer is uncommon and typically only affects those without Pap smears or seeing their doctor regularly.

Cervical Abnormalities and Precancerous Cells Treatment

The treatment for precancerous cells is contingent on several factors, including age and the degree of cell alterations. Most clinicians employ a wait-and-see approach with more frequent Pap smears and colposcopies for mild instances to verify the patient’s body is mending and not deteriorating. Those with severe conditions have the following choices to consider.

LEEP

Loop electrosurgical excision procedure (LEEP) uses electricity to eliminate aberrant cervix cells in the office. Using an electric current to heat a wire loop, cells are removed from the cervix, which is then cauterized to stop the bleeding. The average recuperation period for the cervix is between four and six weeks.

Cone biopsy

A cone biopsy is a technique involving the removal of a cone-shaped section of the cervix (one that includes precancerous cells). This is often conducted under anesthesia in a hospital or outpatient facility. Normal healing time following a cone biopsy is four to six weeks.

Freezing and laser

This office method, known as cryotherapy, employs a chemical to freeze aberrant cells, which are then shed normally. The hope is that normal, healthy cells will proliferate in their place, avoiding the development of cervical cancer. According to Planned Parenthood, this method is 85–90% successful at eliminating aberrant cells without recurrence.

Is HPV a Factor in Fertility?

The HPV virus by itself should not have a significant effect on fertility. Although a study indicated that IVF patients who tested positive for HPV were less likely to conceive than those who tested negative, the reason for this finding is unknown. Researchers hypothesize that an embryo may have a more difficult time implanting in individuals whose immune systems are unable to clear the virus, but remember that the vast majority of individuals infected with HPV are able to eliminate it quickly after infection.

However, treatment for precancerous cells may marginally increase the risk of infertility. Cryotherapy, LEEP, and cone biopsy may constrict the cervix and alter the nature of your cervical mucus, which can delay sperm and make it more difficult for them to fertilize your egg.

Dr. Monk states that your overall risk of infertility is extremely low. Although no particular studies have been conducted in this area, he predicts that these procedures may have less than a 5% impact your capacity to conceive. However, you will likely be recommended to abstain from sexual activity for a month or so after undergoing any of these treatments, which could delay your intentions to conceive.

HPV and the Risk of Pregnancy

In most situations, having the HPV virus in your system should not affect your pregnancy, and your baby will not get it. If you have HPV-caused genital warts, your doctor may observe you more closely; however, pregnant women with this condition typically have healthy pregnancies and can even give birth vaginally.

Dr. Monk warns that using procedures such as LEEP or cone biopsy during pregnancy to address cervical precancerous cells can raise the risk of miscarriage or premature birth. These operations increase the risk of cervical incompetence, a condition in which the cervix dilates prematurely. But, your physician can monitor your cervix with ultrasounds. They may suggest bed rest or a cerclage, a stitch that strengthens the cervix, to prevent this from occurring.

Should I Be Vaccinated Against HPV?

The HPV vaccine (Gardasil 9) is now recommended for females aged 9 to 26 and boys aged 9 to 21; however, the Food and Drug Administration (FDA) has recently approved it for individuals aged 27 to 45.

It is highly efficient in lowering HPV infection and abnormal Pap test results. Moreover, the HPV vaccine can prevent the spread of genital warts and other malignancies caused by HPV, including those of the penis, head, and neck.

According to a published study in The Lancet, the benefits of the HPV vaccine are extensive. In fact, it indicates that abnormal Pap smear results decreased by fifty percent in females aged 15 to 19 around five to nine years following vaccination. The study also revealed that the benefits of the vaccine extend to those who have not been vaccinated, as fewer individuals are HPV carriers. Some specialists believe that the vaccine could eradicate cervical cancer entirely.

Four of the most dangerous strains of HPV are protected against by the HPV vaccine: the two that cause cervical cancer and the two that cause genital warts. “But even if you’ve had abnormal Pap tests or tested positive for HPV, it’s still a good idea to get vaccinated because it’s impossible to tell which strains you truly have,” explains Dr. Monk.

However, receiving the HPV vaccine does not fully prevent the chance of developing cervical cancer. The vaccination protects against two strains that cause over 70% of cervical cancers, but, even if you are vaccinated, you can still get other types of cervical cancer, and you must continue to undergo routine Pap tests.

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