Reacción a "High-risk Human Papillomavirus (HPV) genotypes linked to reduced male fertility"

Human papillomavirus (HPV) infection is considered one of the most common sexually transmitted infections worldwide. It is estimated that up to 80% of the sexually active population (both men and women) may come into contact with the virus at some point in their lives, even if they are not aware of it.

This widespread prevalence has made it difficult to establish a connection with infertility until in-depth studies on this matter have been conducted, most of which have focused on women. Traditionally, women are screened for the presence of the virus during annual gynecological check-ups (through cytology, and later specifically for HPV). The reason is that there are different genotypes of this virus, categorized as low or high risk, with two of the latter being responsible for cervical cancer. Recently, there has been a notable increase in penile, rectal, or even oropharyngeal cancers associated with high-risk HPV in men who engage in unprotected sexual activity. In women, the infection with this virus has been linked to reproductive issues, as surgeries to remove lesions caused by the virus are necessary. However, a significant biochemical link between infertility and being carriers of high-risk HPV has not been observed in women.

The general population, especially men, is largely unaware of the consequences that can arise from the transmission of this virus. Men, even when they are carriers, do not undergo regular check-ups and unknowingly transmit the virus to all their sexual partners, since the potential consequences are long-term rather than immediate. Fortunately, in 2008, free vaccination began for girls at the age of 12, and as of last year, though in my opinion too late, the vaccine is also being administered to boys of the same age group.

The published study links high-risk HPV carriers with infertility in men. These men showed significantly higher levels of sperm necrosis and a greater proportion of sperm with reactive oxygen species, responsible for the oxidation and fragmentation of sperm DNA, which can block cell divisions and, therefore, embryo development, as well as cause miscarriages during the first trimester. Additionally, a reduction in semen leukocytes and inflammatory cytokines (IL-6 and IL-1β) was observed in this group of men. It is important to note that these adverse effects are not detected in routine semen analyses when a couple seeks assistance from reproductive clinics.

The authors suggest thorough HPV screening in men, including genotype determination, in urology and fertility clinics, which I agree with, as more conclusive evidence could be obtained to corroborate the data from this study, which still has a low sample size to fully understand the importance of this infection in male infertility.