The Influence of Human Papillomavirus Infection on Reproductive Outcomes Following IVF: A Systematic Review and Meta-Analysis

Background & Objective: Human Papillomavirus (HPV) is common in reproductive-age populations, but its influence on assisted reproductive outcomes remains uncertain. This systematic review and meta-analysis evaluated the association between HPV infection and clinical pregnancy, live birth, and miscarriage after In Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI). Materials & Methods: PubMed, Scopus, and Web of Science were searched from inception through ۲۰۲۴. Eligible reports compared HPV-positive and HPV-negative groups undergoing IVF/ICSI and confirmed HPV using DNA-based testing. Observational studies and comparative clinical reports were eligible. Random-effects models were used to pool Odds Ratios (ORs) with ۹۵% Confidence Intervals (CIs), coded as HPV-positive versus HPV-negative. Because one study assessed seminal HPV in the male partner and reported cumulative assisted-reproduction outcomes, it was evaluated in sensitivity analysis rather than the primary female/couple-exposure analysis. Results: Nine reports were included. In the primary analysis, HPV positivity was not significantly associated with clinical pregnancy (۸ studies; OR ۱.۱۸, ۹۵% CI ۰.۸۷-۱.۶۰; I²=۱۴.۷%) or live birth (۸ studies; OR ۰.۹۶, ۹۵% CI: ۰.۷۳-۱.۲۷; I²=۰%). Miscarriage showed a non-significant trend toward higher odds with HPV positivity (۸ studies; OR ۱.۶۴, ۹۵% CI ۰.۹۶-۲.۸۰; I²=۰%). Including the seminal HPV-only study increased the pooled miscarriage estimate (۹ studies; OR ۱.۹۹, ۹۵% CI: ۱.۱۴-۳.۴۶; I²=۱۲.۷%), indicating sensitivity to the site and definition of HPV exposure. Conclusion: Current evidence does not demonstrate a clear reduction in clinical pregnancy or live birth after IVF/ICSI among HPV-positive patients. A possible association with miscarriage remains uncertain and appears sensitive to whether seminal HPV studies are pooled with female/couple HPV exposure. Better-designed prospective studies with standardized HPV sampling and reproductive-outcome definitions are needed.

کلیدواژه ها:

Human papillomavirus ، HPV ، In vitro fertilization ، IVF ، Intracytoplasmic Sperm Injection ، Clinical pregnancy ، Live Birth ، Miscarriage ، meta-analysis