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HPV and fertility

Cervical cancer is a diagnosis that affects more than 12,000 women in the U.S. per year. When medical experts dug deeper into these diagnoses, they found that Human papilloma Virus (HPV) is found in about 99% of cervical cancers. While these figures can be alarming, it’s important to note that there are more than 100 different types of HPV and most are considered low-risk and do not cause cervical cancer. As the second most common type of cancer for women worldwide, cervical cancer is also one of the most preventable.

HPV is estimated to be the most common sexually transmitted infection in the country. Approximately 80% of women will be infected with some type of HPV by age 50. That breaks down to four out of five women! It is estimated that there are approximately 79 million people in the U.S. with HPV, and there are 14 million new infections each year.

Three HPV vaccines are available, and it is recommended that females and males receive the vaccine before age 26. This is helpful in the younger population, but a large population of men and women came in contact with HPV after they were sexually active and before the vaccine was available.

Preventing an HPV transmission can prove tricky as it is passed through skin-to-skin contact of the genital and anal areas. While condoms protect the skin they cover, they do not exhaustively protect the genital area. Men are not tested for HPV and will likely never know they are infected. Women typically learn of an HPV diagnosis after a Pap smear with their Ob/Gyn.

Given how easily HPV can be transmitted and the challenges in ease of protection, its pervasiveness is far from surprising. If you have not received an HPV vaccine and are of childbearing age, it is important to understand how HPV and cervical cancer can impact your family planning.

Cervical Cancer Symptoms

When cervical cancer is in the early stages, no major symptoms arise. For this reason, it is important to visit your Ob/Gyn regularly for a Pap smear. Annual cervical cancer deaths have steadily declined as a result of awareness and regular Pap visits.

If you are experiencing abnormal bleeding, pelvic pain unrelated to your menstrual cycle, pain during sex, increased urinary frequency, pain during urination or unusual and heavy vaginal discharge, contact your physician. These symptoms can also signal other health issues unrelated to cervical cancer, but it is important to address them immediately.

Treatment and Fertility Preservation Options

Should your physician diagnose cervical cancer, it is important to consider your future family planning goals prior to treatment. Have an honest discussion with your doctor about how cancer treatment will impact your future reproductive abilities.

Precancerous cells are typically removed by freezing and destroying abnormal tissue through cryosurgery, or removing cells with an electrically charged wire loop known as LEEP.

Early stage cancer treatments may allow for a less invasive treatment regimen that lessens the impact to your reproductive abilities. Early stage treatment options may include a radical trachelectomy (removal of cancer while leaving the internal opening of the cervix), a cone biopsy (removal of a cone-shaped piece of the cervix) or a LLETZ (removal of the cervical area where abnormal cells are likely to develop).

If the cervical cancer has progressed, a hysterectomy (removal of the womb) may be necessary. Another treatment option known as radiotherapy also can disrupt ovarian and uterine function necessary to conceive and carry a pregnancy. Both treatment options prevent the possibility of carrying a future pregnancy. If possible, freeze eggs or embryos prior to treatment, which can later be implanted in a surrogate.

Learn more about fertility preservation options, including freezing eggs and embryos

How HPV Affects Fertility

The good news is that an HPV diagnosis alone should not affect the ability to get pregnant. Should an HPV diagnosis cause precancerous cells in the cervix, minor treatment through cryosurgery or LEEP will be necessary. These procedures for the most part do not affect reproductive potential.

However, undergoing multiple procedures to remove precancerous cells or removing larger areas of cervical tissue can make pregnancy more difficult. Cell removal can decrease production of cervical mucus, which serves to help sperm swim up the reproductive tract. Removal are larger areas of tissue can weaken the cervix and increase chances of miscarriage.

The best advice is to visit your Ob/Gyn doctor annually, stay current on your Pap smear tests, and to treat precancerous cells quickly before they progress.

*cited statistics courtesy of the National Cervical Cancer Coalition

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