BACKGROUND 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. METHODS 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. RESULTS 8.1% reported any infertility. Neither model revealed any association between HPV vaccination at any age and self-reported infertility, regardless of marital status. CONCLUSION 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.

中文翻译：

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在18-33岁的美国女性中，HPV疫苗接种与不孕之间没有关联。

背景技术在美国，人类乳头瘤病毒（HPV）疫苗已被推荐作为与HPV相关的癌症的主要预防方法已有10多年的历史，并且有证据表明，接种疫苗后HPV感染的发生率降低了。然而，已经有人担心HPV疫苗可能会降低生育能力。这项研究在全国代表性的样本中检查了HPV免疫与自我报告的不育之间的关系。方法分析了2013-2016年美国国家健康和营养调查的数据，以评估20至33岁女性中自我报告的不育症的可能性，这些妇女年龄尚小，可以接受HPV疫苗接种，年龄大到可以接受不孕症查询（ n = 1114）。按婚姻史分层的两个逻辑回归模型，研究了HPV疫苗接种与不孕之间的潜在关联。模型1评估了从未怀孕或在HPV疫苗接种前怀孕的妇女中不孕的可能性。模型2通过纳入所有报告了不育期12个月的20-33岁女性，解释了潜在的和/或永久的疫苗后不孕症的可能性。结果8.1％的患者表示不育。两种模型均未显示任何年龄的HPV疫苗接种与自我报告的不育之间的任何关联，无论其婚姻状况如何。结论没有证据表明接受HPV疫苗的女性的不孕症增加。这些结果为HPV疫苗安全性提供了进一步的证据，并应使提供者有信心推荐HPV疫苗接种。