Sexually transmitted infections (Chlamydia trachomatis, genital HSV, and HPV) and female fertility: A scoping review

Abstract

More than one million sexually transmitted infections (STIs) are acquired every day worldwide. They are commonly caused by Chlamydia trachomatis (CT), herpes simplex virus (HSV), or human papillomavirus (HPV) and are suggested to contribute to female infertility. This scoping review aims to map and summarize existing literature on the association between a pre-pregnancy infection with CT, genital HSV, or HPV and female fertility.

We searched two databases (PubMed, Embase) to identify published literature on the association between CT, genital HSV, or HPV infection and female fertility. We included full-text articles, published from 2002 to 2022, on pre-pregnancy infection with either CT, genital HSV, or HPV within a population of women of reproductive age. The study endpoint was either pregnancy, time-to-pregnancy, or infertility. The included studies were evaluated according to the Critical Appraisal Tool by Joanna Briggs Institute.

Eight studies were eligible for the review. All of them investigated the association between a CT infection and fertility, while none of them investigated infections with genital HSV or HPV. Three studies found that a CT infection was associated with poorer female fertility, and one study found a similar association in a subgroup analysis of women with a pregnancy intention. Four studies indicated no association, although methodological differences between the studies preclude firm conclusions.

This review revealed sparse literature investigating the association between CT, HPV, and HSV and subsequent female fertility. Prospective cohort studies with preconception assessments of these STIs are needed to determine the relation between STIs and subsequent fertility.