The negative impact of most relevant infections on fertility and assisted reproduction technology

Infections may act with variable impact on the physiopathology of the reproductive organs, determining infertility or reducing the outcomes of assisted reproduction technology. The aim of this narrative review is to describe the existing evidence regarding the pathogens with a supposed or recognized role in reproductive medicine. Viral hepatitis, as well as HIV, can reduce sperm quality. Syphilis carries a risk of erectile dysfunction and increased endometrial thickness. Chlamydia is the main cause of pelvic inflammatory disease. In relation to Mycoplasma and Ureaplasma spp., only lei\ species seem to show a correlation with infertility and poor in-vitro fertilization outcomes. There is evidence of a role for bacterial vaginosis in early pregnancy loss. HPV infection in males seems to determine infertility. Herpesviruses are more a risk for fetuses than for fertility itself. Zika virus is responsible for altered early embryo development and waiting to conceive is recommended in suspected or confirmed cases. The impact of SARS-CoV-2 is yet to be elucidated. Rubella and toxoplasmosis can provoke important congenital defects and therefore screening is mandatory before conception; a vaccine for Rubella is recommended. Further and well-designed studies are still needed to better elucidate the role of some infectious agents. to improve fertility and its treatments.

Automated summary

Infections can have varying impacts on reproductive organs, potentially causing infertility or reducing the effectiveness of assisted reproduction technology. This review examines the evidence for pathogens that play a role in reproductive medicine. Viral hepatitis and HIV can reduce sperm quality, while syphilis increases the risk of erectile dysfunction and thicker endometrial lining. Chlamydia is the main cause of pelvic inflammatory disease, and certain species of Mycoplasma and Ureaplasma can be correlated with infertility and poor IVF outcomes. Bacterial vaginosis is associated with early pregnancy loss. HPV infection in males may lead to infertility. Herpesviruses pose a greater risk to fetuses rather than fertility itself. Zika virus affects early embryo development, and waiting to conceive is advised in suspected or confirmed cases. The impact of SARS-CoV-2 is still not fully understood. Rubella and toxoplasmosis can cause congenital defects, hence mandatory screening and Rubella vaccination is recommended. Further studies are needed to better understand the role of infectious agents in improving fertility and its treatments.