Should I wait for Human Papillomavirus (HPV) to clear before conceiving?

HPV Infection and Conception: Waiting for Clearance

Most HPV infections clear spontaneously within 1-2 years, and HPV does not affect a woman's fertility or ability to carry a pregnancy to term, so waiting for HPV to clear before conceiving is generally not necessary. 1, 2

Understanding HPV Clearance and Pregnancy

HPV is extremely common, with most sexually active adults acquiring it at some point in their lives. The natural history of HPV infection is well-documented:

• 70% of new HPV infections clear within 1 year
• Approximately 90% clear within 2 years 2
• The median duration of new infections is 8 months 1

Key Facts About HPV in Pregnancy

• HPV infection does not impair fertility or the ability to carry a pregnancy to term 1, 3
• Pregnancy itself does not worsen HPV-related disease progression
• While some studies have suggested associations between HPV and adverse pregnancy outcomes, the evidence is inconsistent 4

Special Considerations

For Women with Genital Warts

• Genital warts (caused by HPV types 6 and 11) may proliferate and become more friable during pregnancy 1, 3
• Treatment options during pregnancy are more limited:
  • Safe during pregnancy: Cryotherapy with liquid nitrogen, trichloroacetic acid (TCA), surgical removal 3
  • Contraindicated during pregnancy: Podophyllin, podofilox, imiquimod, and sinecatechins 1, 3

For Women with Abnormal Cervical Screening

• If you have abnormal cervical screening results, follow recommended management before attempting conception
• Close follow-up of cervical abnormalities is essential to prevent progression 1

Vertical Transmission Risk

• The risk of HPV transmission to infants is low (approximately 7% in recent studies) 5
• Even when transmission occurs, most infections in infants clear by 6 months of age 5
• The risk of juvenile-onset recurrent respiratory papillomatosis (JORRP) in infants is very low 1, 3
• Cesarean delivery is NOT recommended solely to prevent HPV transmission 1, 3

Vaccination Considerations

• HPV vaccination is not recommended during pregnancy 6
• If planning pregnancy, consider completing HPV vaccination before conception if eligible
• The quadrivalent vaccine protects against HPV types that cause 90% of genital warts (types 6 and 11) and 70% of cervical cancers (types 16 and 18) 1

Conclusion

For most women with HPV infection, there is no medical reason to delay conception. The infection does not affect fertility or pregnancy outcomes, and most infections clear naturally within 1-2 years. Focus instead on appropriate screening, treatment of any cervical abnormalities, and following standard prenatal care recommendations.

If you have active genital warts, discussing treatment options with your healthcare provider before conception may be beneficial, as some treatments are contraindicated during pregnancy.