HPV Prevalence and Genotype Distribution Among Infertile and Fertile Women of Turkish Nationality and Association with Cytology and Vaccination Status.

Background/Objectives: Human papillomavirus (HPV) is one of the most common sexually transmitted infections, yet its role in female infertility remains uncertain. This study aimed to compare HPV prevalence and genotype distribution between infertile and fertile women and to evaluate demographic and clinical factors, together with HPV vaccine coverage, in both groups. Methods: Cervical samples from 200 infertile and 200 fertile women aged 18-45 years were analyzed for 28 HPV genotypes using multiplex real-time polymerase chain reaction (PCR). Results: HPV DNA was detected in 13.5% (27/200) of infertile women and 18.0% (36/200) of fertile women (p = 0.272). The most frequent genotypes were HPV-82 (5/200, 2.5%) and HPV-16 (5/200, 2.5%) in infertile women, and HPV-45 (8/200, 4.0%) and HPV-16 (7/200, 3.5%) in fertile women. Single HPV infections were more common in infertile women (81.5%, 22/27) than in fertile women (63.9%, 23/36). HPV positivity was not associated with reproductive, clinical, or lifestyle factors, and age-stratified analyses revealed no statistically significant differences (all p > 0.05). Among women aged 30-45 years, atypical squamous cells of undetermined significance (ASC-US) cytology was identified in eight infertile women, all of whom were HPV-negative, whereas one of nine fertile women with ASC-US was HPV-positive. No low-grade squamous intraepithelial lesion (LSIL) cases were detected in the infertile group. The 9-valent HPV vaccine covered 56.2% (18/32) of genotypes detected in infertile women and 45.1% (23/51) of those detected in fertile women. Conclusions: In this study, no significant differences were observed between the groups in terms of HPV prevalence, genotype distribution, or cytology findings. These results suggest that HPV is not an independent risk factor for infertility and highlight the need for further studies focusing on genotype-specific patterns, viral persistence, and biological mechanisms that may influence reproductive outcomes.