Q : I am 24 years old and recently married. I?ve been sexually active sinceturning 21 and realised I contracted warts only this year. I?ve been treatedsince.

What are the chances of the warts recurring? Can they be totally cured? My mainconcern here is my wife. Unfortunately, she has been infected with internal andexternal warts. Will we be able to conceive naturally in the future? I?mworried as we are planning to start a family in two years.

A: Penile warts are single or multiple cauliflower-like growths that appear onthe penis. They are caused by human papilloma virus (HPV), a group of viruswith more than 100 different types. The virus can infect the anus and rectum aswell as genital areas of females, including the birth canal (vagina), areaoutside the vagina (vulva) and neck of the womb (cervix).

The virus spreads primarily through sexual contact. As it usually causes nosymptom, the infection can be transmitted to the sexual partner unknowingly.

Some people can become a ?silent? HPV carrier many years after they have hadsex with an infected person.

There is no treatment or cure for HPV. The infection usually clears on its ownor may persist as warts, which can then be treated with medication, surgery orfreezing with dry ice. Some warts may recur especially in the first threemonths after treatment. It is not known whether treatment of genital warts willreduce the chance of passing the virus to the sexual partner.

Although transmission of HPV infection is reduced by the use of condoms,medical studies have shown that this does not provide complete protection.Infection can occur in genital areas that are covered by condoms as well asexposed areas.

The health problem of HPV infection is that some infection may cause cancer ofthe cervix, vagina, anus or penis. Since your wife is already infected withHPV, it is important that she should be checked by the gynaecologist regularlyfor abnormalities at the cervix. Periodic smear tests (Pap smears) andtelescopic examination of the cervix (colposcopy), with treatment if necessary,can help ensure that pre-cancerous changes in the cervix do not develop intolife-threatening invasive cancer.

As far as fertility is concerned, both you and your wife should be thoroughlyinvestigated and treated for other sexually transmitted diseases as these maybe present together with HPV and reduce your chances of conception. The qualityand quantity of your sperm may be affected and the fallopian tubes of your wife(the passage where sperm meets the egg) may be blocked. Your wife may be ableto conceive naturally in future. However, do not leave fertility to chance.

This story first appeared in Mind Your Body on Jan 31, 2007.

DR PETER CHEW, CONSULTANT OBSTETRICIAN AND GYNAECOLOGIST, GLENEAGLES HOSPITALDr Chew is also a founding member of aLife, a voluntary welfare organisationdedicated to nurturing a healthy respect for fertility and family life. Formore information, visit www.alife.org.sg