Human papillomavirus infection in males: implications for fertility, assisted reproductive outcomes, and vaccination strategies.

Abstract

Human papillomavirus (HPV), a prevalent sexually transmitted infection, is increasingly recognized as a critical determinant of male reproductive dysfunction. This comprehensive review consolidates evidence on HPV-mediated mechanisms impairing semen quality, inducing sperm DNA fragmentation, and facilitating paternal-fetal transmission, which collectively contributes to spontaneous abortion and assisted reproductive technology (ART) failure. While debates persist on the direct causal role of HPV in infertility, emerging data highlight the efficacy of male vaccination in reducing the seminal viral load, improving pregnancy rates, and lowering miscarriage risk. We propose integrating HPV screening into male fertility assessments and advocating gender-neutral vaccination programs to increase ART success and mitigate vertical transmission. Future research should delineate HPV-induced epigenetic alterations and validate novel sperm preparation techniques for optimizing reproductive outcomes.