Myths vs facts: Helicobacter and Fruchtbarkeit

The claim that Helicobacter pylori infection impairs fertility is a topic of debate. Some observational studies suggest possible links: H. pylori may affect sperm quality (e.g., reduced motility, DNA fragmentation) and female fertility (e.g., chronic endometritis, implantation failure) through inflammation or molecular mimicry. However, the evidence is weak and inconsistent. Most studies are small, cross-sectional, or case-control, with significant confounding factors (lifestyle, other infections, socioeconomic status). No large randomized controlled trials have confirmed a causal effect. Therefore, it remains a hypothesis rather than an established fact. In clinical practice, routine H. pylori screening for infertility is not recommended. Standard fertility workup (hormones, semen analysis, tubal patency) should take priority. Eradication therapy is indicated for symptomatic H. pylori infection (e.g., peptic ulcer, gastritis) but not solely to improve fertility. The idea that H. pylori is a major cause of infertility is a myth not supported by strong evidence.