Question: About 12-13 years ago, I contracted genital warts from my previous boyfriend. I am now happily married for about 8 years and haven't really thought about it.  Now I read on your web site that I could pass this disease to my husband and to the baby we are going to try to make soon (in about three or four months). Should we start using condoms every time we have sex and try to adopt?

Answer: There is no reason for you to avoid pregnancy just because you have a history of genital warts. And if you have had regular unprotected intercourse since you got married there is really no need to use condoms now because chances are that your husband has already become infected.

Human papilloma virus (HPV), the virus responsible for genital warts (condylomata accuminata or venereal warts) is a very contagious sexually transmitted disease, which is spread by sexual contact with an infected partner. Approximately two-thirds of persons who have sexual contact with a partner with genital warts will become infected with HPV, usually within 3 months of contact.

Wearing condoms can significantly decrease the risk of infection if one partner is already infected, and the other is not, but is not useful for prevention if both partners are already infected.

If you really want to find out whether your husband has become infected, you both may want to consider doing a blood test for HPV.

Like many other sexually transmitted diseases, HPV often causes little to no symptoms, especially in men, and the fact that your husband has no symptoms does not necessarily mean he’s not infected.

Asymptomatic HPV infection cannot and does not need to be treated. Not unlike herpes, it will stay with you forever. Sometimes if a wart becomes too big it might need to be surgically removed or treated with a solution which will make it shrink or disappear.

HPV infection does not interfere with a woman's ability to get pregnant. Nor does it prevent her from having a healthy and successful pregnancy. Studies have shown that women infected with HPV have the same proportion of healthy babies as women who test negative for HPV.

There are several other issues related to HIV and pregnancy, though they are extremely rare, that you need to know about:

During pregnancy, warts may occasionally get larger. This is probably due to increasing levels of pregnancy estrogens.

Genital warts located on the external female genitalia such as the labia, can occasionally grow larger in pregnancy. This may sometimes prevent the baby from passing through the birth canal, and occasionally requires a cesarean section.

Warts that are located and grow inside the vagina, may make the vagina less elastic.

But both of these complications are extremely rare in pregnancy, and they should not prevent you from trying to get pregnant.

If warts grow too large, they can be surgically removed, even in pregnancy, and preferably before labor to ensure a normal labor and delivery.

There have been case reports of some babies who were born to HPV infected mothers and who developed a growth called “papilloma” in their throat or on their external genitalia. But these complications are so rare, that a cesarean section is not routinely recommended in HPV infected women to prevent this complication.

The most significant potential problem of genital HPV infection is it’s association with cervical cancer. A woman who has been infected with HPV should therefore be regularly screened  with a Pap smear for possible cervical HPV infection and precancerous lesions of the cervix.

Preconception, the time period when you are trying to conceive, is the best time to do the Pap smear. If treatment for HPV is indicated, it is easier to do it before pregnancy than during pregnancy.

While getting your preconception Pap smear, it’s also a good idea to get checked at the same time for other sexually transmitted diseases. Treatment for STDs in general is less complicated before pregnancy than during pregnancy.

And while you are with your provider, you might also tell her that you are planning to get pregnant and discuss possible other preconception issues.