Evidence check: Helicobacter in the context of Fruchtbarkeit

The link between Helicobacter pylori and fertility remains inconclusive. Some studies suggest that chronic H. pylori infection may impair sperm quality (motility, morphology) and female reproductive outcomes (implantation failure, miscarriage) through systemic inflammation, oxidative stress, or molecular mimicry triggering autoantibodies. However, the evidence is limited: most studies are observational, small, or confounded by other factors. A few meta-analyses show modest associations, but no large randomized trials have proven causality. Mechanistically, H. pylori is primarily a gastric pathogen; direct effects on reproductive tissues are plausible but not firmly established. In clinical practice, routine H. pylori screening for infertility is not recommended unless gastrointestinal symptoms are present. Eradication therapy may improve fertility in some cases, but the effect is inconsistent. Consumer tests (e.g., microbiome kits) can detect H. pylori but are not diagnostic and should not replace medical evaluation. Evidence: mostly mechanistic and observational, rated 'unclear'.