Sexually transmitted infections, even those that you may have had long before getting married, can cause you to be infertile in the process. This may seem scary, but it is true.
It is ironic that the more you’ve had sex in your past, the less fertile you may be, particularly if you were exposed to the risk of any STI which can make both women and men infertile.
It is not uncommon to be diagnosed with infertility as a result of infection from gonorrhoea, chlamydia or other STIs. If you have a STI there may be no symptoms, yet STIs can damage your reproductive organs and diminish your fertility.
Sexually transmitted infections are common. However, people who have a STI often have no symptoms and can therefore have the infection for some time without being diagnosed or treated.
Note that STIs like chlamydia, gonorrhoea, syphilis, and mycoplasma genitalium can cause fertility problems, especially when left untreated.
Also be aware that having unprotected sex with someone that is infected can easily transmit chlamydia which is a common infection that can affect anyone who has had unprotected sex.
It is true that a STI can affect your chances of having a baby if it is not properly treated. For instance gonorrhoea is a bacterial infection that can affect both men and women.
It is easily transmitted during vaginal intercourse and usually affects the genital area, although the throat or anus may also be affected.
Usually, women with gonorrhoea often don’t have any symptoms. This means that gonorrhoea can go undetected for a long time. When symptoms do occur, they include an unusual discharge from the vagina and pain while urinating.
However, men do experience symptoms including burning sensation while urinating and a white or yellow pus-like discharge from the penis.
Untreated, gonorrhoea can lead to pelvic inflammatory disease, which can cause infertility. When you experience PID, there is lower abdominal pain and tenderness, deep pain during sexual intercourse, heavy and painful periods and fever.
As a woman, if you have had PID, you need to be especially careful about gonorrhoea, because the risk of infertility increases with each bout of inflammation.
The earlier STIs are diagnosed and treated, the less likely they are to cause problems with your fertility. If you have had unprotected sex and have symptoms of STIs, it is advisable that you consult your doctor promptly for a check-up.
In several instances it might be awkward or embarrassing for you dealing with such diagnosis, but STIs are not to be ignored. Apart from the risk of infertility, having an STI test before trying for a baby reduces the risk of passing such infection on to your partner or child.
Left untreated, an STI can adversely affect your fertility and other reproductive outcomes.
Prompt treatment with antibiotics reduces the risk of complications.
If you are thinking about having a baby, one of the precautions you can take to increase your chance of getting pregnant and having a healthy baby is to be screened for STIs and treated.
Do not be worried by the fact that these infections seem to affect women more. Actually up to 85 per cent of women that have had chlamydia don’t even realise they’ve had it.
As mentioned earlier, an STI cannot only affect mothers and fathers, but even their children. An infection known as chlamydial conjunctivitis is common.
Just a single event of pelvic inflammatory disease can cause you to have blocked fallopian tubes, as well as chronic pelvic pain. Even if your fallopian tubes aren’t completely closed, they can still have damage that can be missed.
Only a fertility evaluation that thoroughly examines the fallopian tubes, as well as uterine health and ovarian reserve, may successfully pick up problems that might have been missed.
There are basics to understanding how STIs and fertility overlap. But the first thing you need to understand is what an STI is, and that it is passed from one person to another mainly through intimate sexual contact, which can be “heavy petting,” vaginal or anal sexual intercourse, and oral sex.
There are dozens of STIs including syphilis, gonorrhoea, chlamydia, herpes, human papillomavirus and others. But gonorrhoea and chlamydia are the ones most likely to cause subfertility (reduced fertility).
Most sexually active people are quite familiar with STIs and they know that they don’t want to have one.
However, roughly three out of four women will get some type of STI in their lifetime. The infections are most common in women under age 25, and up to 80 per cent of women with chlamydia get it between age 15 and 25.
The problem is that you will not know that you have such infections if you are not tested. Worse still, there is a greater likelihood of you spreading the infections.
The best practice, particularly if you are trying to get pregnant, is to be tested for STIs and get treated if necessary.
Gonorrhoea and chlamydia, which are preventable, are the two STIs most likely to result in infertility because they can cause PID in women.
This can inflame and scar the fallopian tubes, making it hard for sperm and eggs to find each other, blocking pregnancy. Chlamydia and gonorrhoea can also cause the urethra in the lower part of the urinary tract.
Gonorrhoea and chlamydia often show no symptoms, so that’s another concern and reason to be tested. If untreated, chlamydia can trigger PID, which occurs in the upper part of the genital tract affecting the uterus, fallopian tubes and surrounding tissues in those areas.
This can cause infertility, with cases of acute PID being particularly damaging to fertility. The information for you is that screening for gonorrhoea and chlamydia is simple and inexpensive. It involves a urine sample.
Treatment is also relatively easy. There is a dual therapy of two drugs, one an injection, the other an oral medication. Because gonorrhoea and chlamydia often occur at the same time, this dual approach can cure both.
If you have other infections like HPV and herpes simplex virus they don’t directly cause infertility, but HSV can make you more vulnerable to other infections.
Couples with HSV must abstain from sex until the sores have healed, and HPV can progress to cervical (and other) cancer, and the treatments can sometimes make you less fertile.
Though STIs are more detrimental to female fertility, if as a man you have gonorrhoea or chlamydia, it can render you infertile because the infection can block the epididymis. These are the long, coiled tubes at the back of the testicles that store and then carry sperm during ejaculation.
A blocked epididymis can mean that no sperm gets to your eggs during intercourse. If you suspect that you are having trouble, you need to haveyour fertility assessed.
The most likely way that a man with an STI can cause infertility is if he passes the disease to his female partner. Then she becomes infertile, as described above.
It could also affect fertility by causing you to abstain from sex in order to heal and not spread the disease.
For couples seeking to have children, the biggest issue with STIs is damage to the woman’s fallopian tubes and potentially even the uterus.
As explained previously, the two fallopian tubes pick up eggs from the ovaries, so if the tubes are closed at that end from a previous infection, there won’t be many (or any) eggs for the sperm to find and fertilise in order to make an embryo.
Also, even if your tubes are only partially blocked, and sperm and egg manage to find each other, the damage can still prevent an embryo from making it back to the uterus, resulting in an ectopic pregnancy, which is a dangerous condition.
Additionally, very bad pelvic infections can scar the uterus, resulting in Asherman’s syndrome, a condition that makes it difficult for an embryo to attach or develop.
It is often recommended to check whether the fallopian tubes are open or whether STIs (or other factors) may have resulted in scarring.
If there is a blockage in the fallopian tubes or other problems are found, additional evaluation and treatment may be necessary. Minimally invasive surgeries such as laparoscopy may be necessary to repair the tubes.
If only one fallopian tube is blocked, pregnancy is still possible. If you are trying to have children, you should try your best to prevent getting a STI. If you think it’s possible you have a STI, be tested and have it treated.
If you suspect a STI–or anything– is preventing you from getting pregnant, get in touch with a reputable fertility expert.
Dr Abayomi Ajayi
@ Punch Newspaper