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ABSTRACT: Objective
This study investigated whether women with a history of human papillomavirus (HPV) infection have an increased risk of infertility.Material and methods
All patients with an HPV infection (n = 11,198) in Taiwan's National Health Insurance Research Database (2000-2012) were propensity score matched with control subjects (n = 11,198) without an HPV infection by age, sex, index year, and relevant co-morbidities. Both groups were tracked until a diagnosis of infertility was recorded. The Chi-square test was used to analyze the distribution of demographic characteristics in the HPV group and non-HPV group. A Cox proportional hazards regression was used to estimate the hazard ratios (HRs) for the development of infertility, adjusting for age, sex, and co-morbidities. The Kaplan-Meier method was used to plot the cumulative incidence curves. We also performed negative controls to test for possible unmeasured confounding.Results
The HPV cohort had a higher risk of infertility. The adjusted HR (aHR) was found to be 1.39 (95% CI = 1.19-1.63) after adjusting for demographic characteristics and relevant co-morbidities. In the age subgroup analysis, patients with an HPV infection had an increased risk of infertility compared to the non-HPV cohort in the group aged 26 to 35 years (aHR, 1.53; 95% CI = 1.24-1.88). As we used propensity score matching to treat measurable confounders and negative controls to access unmeasured confounders, the findings of the study are robust.Conclusions
Among females of reproductive age, HPV infection is a potential risk factor that predisposes individuals to subsequent infertility.
SUBMITTER: Hsu LC
PROVIDER: S-EPMC7558487 | biostudies-literature | 2020 Sep
REPOSITORIES: biostudies-literature
Hsu Li-Chuan LC Tsui Kuan-Hao KH Wei James Cheng-Chung JC Yip Hei-Tung HT Hung Yao-Min YM Chang Renin R
International journal of environmental research and public health 20200907 18
<h4>Objective</h4>This study investigated whether women with a history of human papillomavirus (HPV) infection have an increased risk of infertility.<h4>Material and methods</h4>All patients with an HPV infection (n = 11,198) in Taiwan's National Health Insurance Research Database (2000-2012) were propensity score matched with control subjects (n = 11,198) without an HPV infection by age, sex, index year, and relevant co-morbidities. Both groups were tracked until a diagnosis of infertility was ...[more]