Department of Obstetrics and Gynecology, University of Wisconsin, School of Medicine and Public Health, 4th Floor, McConnel Hall, 1010 Mound St, Madison, WI 53715, USA.
University of Wisconsin School of Medicine and Public Health, 750 Highland Ave, Madison, WI 53726, USA.
Vaccine. 2020 May 19;38(24):4038-4043. doi: 10.1016/j.vaccine.2020.03.035. Epub 2020 Apr 3.
Human papillomavirus (HPV) vaccines have been recommended as primary prevention of HPV-related cancers for over 10 years in the United States, and evidence reveals decreased incidence of HPV infections following vaccination. However, concerns have been raised that HPV vaccines could decrease fertility. This study examined the relationship between HPV immunization and self-reported infertility in a nationally representative sample.
Data from the 2013-2016 National Health and Nutrition Examination Survey were analyzed to assess likelihood of self-reported infertility among women aged 20 to 33, who were young enough to have been offered HPV vaccines and old enough to have been queried about infertility (n = 1114). Two logistic regression models, stratified by marital history, examined potential associations between HPV vaccination and infertility. Model 1 assessed the likelihood of infertility among women who had never been pregnant or whose pregnancies occurred prior to HPV vaccination. Model 2 accounted for the possibility of latent and/or non-permanent post-vaccine infertility by including all women 20-33 years old who reported any 12-month period of infertility.
8.1% reported any infertility. Neither model revealed any association between HPV vaccination at any age and self-reported infertility, regardless of marital status.
There was no evidence of increased infertility among women who received the HPV vaccine. These results provide further evidence of HPV vaccine safety and should give providers confidence in recommending HPV vaccination. Further research should explore protective effects of HPV vaccines on female and male fertility.
人乳头瘤病毒（HPV）疫苗已在美国被推荐作为 HPV 相关癌症的主要预防措施超过 10 年，并且有证据表明接种疫苗后 HPV 感染的发病率降低。然而，人们担心 HPV 疫苗会降低生育能力。本研究在全国代表性样本中检查了 HPV 免疫接种与自我报告的不孕之间的关系。
对 2013-2016 年全国健康和营养检查调查的数据进行了分析，以评估 20 至 33 岁女性自我报告不孕的可能性，这些女性年龄足够小，可以接种 HPV 疫苗，并且已经到了询问不孕问题的年龄（n=1114）。两个按婚姻史分层的逻辑回归模型检验了 HPV 疫苗接种与不孕之间的潜在关联。模型 1 评估了从未怀孕或怀孕发生在 HPV 疫苗接种之前的女性不孕的可能性。模型 2 通过纳入所有报告任何 12 个月不孕期的 20-33 岁的女性，考虑了潜在的和/或非永久性的疫苗接种后不孕的可能性。
8.1%的人报告存在任何程度的不孕。无论婚姻状况如何，两个模型均未显示 HPV 疫苗接种与自我报告的不孕之间存在任何关联。
接受 HPV 疫苗的女性不孕的风险没有增加。这些结果进一步证明了 HPV 疫苗的安全性，应该使提供者有信心推荐 HPV 疫苗接种。进一步的研究应该探索 HPV 疫苗对女性和男性生育能力的保护作用。
