Association Between High-Risk Human Papillomavirus Positivity and Ovarian Reserve Markers in Women with Unexplained Oligomenorrhea: A Retrospective Comparative Study

Aim: to evaluate the association between high-risk human papillomavirus (HR-HPV) positivity and ovarian reserve markers, particularly the anti-Müllerian hormone (AMH), in reproductive-age women presenting with unexplained oligomenorrhea. Methods: this single-center retrospective comparative study included women aged 25–35 years with unexplained oligomenorrhea, categorized into an HR-HPV-positive group (n = 257) and an HPV-negative control group (n = 1164). Ovarian reserve was assessed using serum AMH, basal follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and antral follicle count (AFC), with AMH measured irrespective of cycle day and other hormones on cycle days 2–5, while AFC was determined by transvaginal ultrasonography. Clinical and lifestyle variables were recorded, and multivariable logistic regression was used to identify factors independently associated with low AMH (<0.5 ng/mL). Results: the groups were comparable in age, body mass index, and parity. AMH was lower in HR-HPV-positive women than in controls (median 2.2 [IQR 1.0–3.8] vs. 2.7 [1.5–4.4] ng/mL; p < 0.001), as was AFC (10 [8–13] vs. 11 [9–14]; p < 0.001); the absolute differences were small (Cohen’s d ≤ 0.19). Low AMH was approximately twofold more frequent among HR-HPV-positive women (11.7% vs. 6.3%), and age (OR 1.36, 95% CI 1.26–1.47) and HR-HPV positivity (OR 2.07, 95% CI 1.24–3.47) were independently associated with low AMH; the association persisted at an alternative threshold of <1.1 ng/mL (adjusted OR 2.25, 95% CI 1.57–3.23). Conclusion: HR-HPV positivity was associated with lower AMH and AFC values in women with unexplained oligomenorrhea. These findings indicate a group-level association rather than a causal relationship and require confirmation in prospective studies incorporating HPV persistence and reproductive outcomes.