Читать книгу Getting Pregnant For Dummies - Sharon Perkins - Страница 87

Human papilloma virus (HPV) is the most common STD in the United States, now surpassing chlamydia and gonorrhea. HPV is different from human immunodeficiency virus (HIV). HPV is transmitted through vaginal, oral, or anal sex. Most often, HPV will go away because the immune system eradicates the virus. However, certain variations of HPV can cause genital warts or cancer. The cancers associated with HPV infection include cervical, vaginal, anal, penile, and throat cancers.

Like the situation with many viruses, there is no cure — but there is a vaccine. Beyond that, safe sex limits the risk of transmission. While cancer is the major concern with a positive HPV test, newer studies suggest that HPV may also affect fertility. A recent study evaluated the incidence of HPV in couples undergoing IVF. The study detected HPV in 19 percent of the females and 20 percent of the males. For the males who tested positive, there was a reduction in semen concentration, motility, and shape. The authors did not comment about whether this results in a lower pregnancy rate.

Currently, the gold test standard for HPV in women is the PAP smear (a swab of your cervix), as HPV can cause cervical cancer. Cervical cancer develops slowly in the cells that mark the border between the vagina and the inside of the cervix. The initial infection causes cells to change their appearance, and this can be seen by taking cells from this region of the cervix, staining them, and looking at them under the microscope.

Treatment for PAP smears where a number of cells look abnormal includes further investigating the cervix with a device called a colposcope. This device (and the colposcopy procedure) is just a way to magnify the area of the cervix where cervical cancers start. The areas identified by the colposcope can be biopsied, and potential cervical cancer cells identified through this early detection method can be removed. (The removal procedure is commonly called a LEEP procedure, Loop Electrosurgical Excision Procedure).

Prior to knowing that HPV causes cervical cancer, the PAP was the best way to identify these early precancerous changes. But now, it is known that certain variations of the HPV, called serotypes, can identify which people are at risk for developing cervical cancer. So, the more modern PAP is done so that the HPV can be typed and the risk assessed. The use of serotyping has allowed those people who are either HPV negative or have one of the safer variants of HPV to have less frequent PAP smears, such as every three years. Early treatment and more frequent screening can reduce the risk for developing cancer.

There is little data to suggest that HPV has a huge impact on your ability to conceive and, even if you were treated for HPV, the cervical procedures themselves should not increase your infertility risk. So, cancer is a concern with HPV — but impact on fertility, not so much.

A note about the HPV vaccine: While there is a vaccine for HPV, only about 40 percent of females and 28 percent of males who are in the age range where the vaccine is recommended (ages 11–26) actually have been vaccinated. Optimally, the vaccines should be given to all males and females at age 11–12. There are three different vaccines as of this writing, and for the 9-valent vaccine, the upper age for immunization has been increased to 45 years old for both men and women. As of 2019, the CDC did not recommend vaccinating adults over age 45.