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STDs and Infertility

We are constantly reminded to do everything we can to protect ourselves from the dangers of sexually transmitted diseases (STDs). But just because we are more aware of them today than we were 20 years ago does not mean they are any less prevalent.

According to the American Social Health Association, approximately 65 million people in the United States have an STD. It is difficult to pinpoint exactly how many new cases are reported each year because most STDs are "silent," showing either minor symptoms or none at all. This is why they often go untreated and can have serious effects on your reproductive system.

Though chlamydia and gonorrhea have not been proven to have as much of an impact on male fertility as they have on female infertility, they can cause damaging effects to the health of both sexes when left untreated. A man's sperm production could be impeded, or a woman may find herself with severe damage to her reproductive organs, without either of them ever knowing that they had contracted an STD.

Recent studies conducted by the World Health Organization (WHO) show that throughout the world, 38 percent of infertility cases are caused by STDs. Infertility has numerous causes, but the most avoidable cause is STDs.

Chlamydia

One of the "silent" diseases, chlamydia is particularly dangerous among STDs. Seventy-five percent of infected women and at least half of infected men don't know they have the disease because they don't notice any symptoms. With an estimated 3 million new cases in the United States each year, chlamydia is by far the most common bacterial STD.

Without treatment, chlamydia can lead to an infection in women known as pelvic inflammatory disease (PID). PID occurs when the C. trachomatis bacteria move from the cervix, where they enter during intercourse, to the uterus and fallopian tubes. Once the bacteria have spread, they can cause scarring and permanent damage to the reproductive organs including the uterus, ovaries and fallopian tubes. Scar tissue in the fallopian tubes can make the passage of a fertilized egg into the uterus very difficult, and increases the risk of having an ectopic pregnancy, a dangerous condition that requires emergency surgery.

The Centers for Disease Control (CDC) estimates chlamydia leads to PID in up to 40 percent of cases. A woman who suffers a severe case of chlamydia is five times more likely to suffer from infertility than if she develops a mild infection. After one episode of PID, one in twelve women is left infertile, one in five after a second episode, and 40 percent are left infertile after three or more episodes. Prompt treatment of PID, however, can lower the infertility risk significantly.

Symptoms of PID include fever, lower abdominal or back pain, and vaginal discharge. If chlamydia symptoms occur, they usually appear within 1 to 3 weeks of exposure, and might include abnormal vaginal discharge or a burning feeling while urinating.

If a pregnant woman contracts chlamydia, the infection can cause serious complications like premature labor or miscarriage. Babies who are exposed to the bacteria in the birth canal during delivery may be born with pneumonia or an eye infection called conjunctivitis, both of which can be very dangerous if not treated right away.

While we know for sure that chlamydia can cause significant damage to a woman's reproductive system, there is not enough scientific evidence to know whether chlamydia causes fertility problems or other long-term consequences in men.

Gonorrhea

One STD that is known to affect the reproductive tissue in both men and women is gonorrhea. While the number of people in the U.S. with gonorrhea has steadily declined since the mid-1970s, more than 300,000 new cases of the disease still occur every year.

Gonorrhea is a bacterial infection that can be contracted during oral, anal or genital sexual contact. Symptoms may include burning or pain during urination, and a thick, yellowish discharge from the penis or vagina. Unfortunately, like chlamydia, gonorrhea can exhibit no symptoms at all.

Without treatment, gonorrhea may lead to PID in women and cause infertility, among other things. In both sexes, it can spread to the circulatory system and infect the heart, liver, joints and tendons. Gonorrhea can also cause fertility problems in men.

Every year, 500,000 men develop epididymitis as a result of STD infections like gonorrhea. Epididymitis is a painful condition of the testicles which causes inflammation in the one of the vessels which transports semen. If left untreated, it can cause complete blockage of these vessels, resulting in male infertility. Unfortunately, many women with STDs do not develop any noticeable symptoms. As a result, they are less likely to seek the treatment they need, leaving them susceptible to the often devastating effects of STD-related infertility.

How to protect yourself against STDs

Abstaining from sex is the only 100 percent sure way to protect yourself from STDs, but when you're trying to get pregnant, abstinence is not an option! Below is a list of steps you can take to protect yourself from STDs.

• Mutual monogamy - If you and your partner are thinking of starting a family, you probably already have a close relationship with each other. It is important that you know each other well and feel as though you can trust each other. Being faithful, meaning neither person is having sex with anyone else, is a great way to protect yourself from an STD.

• Talk about it - You should also be aware of your partner's sexual history. Your risk of contracting an STD increases with the number of sexual partners you and your partner have had in the past. Get tested for STDs and share your results with each other.

• Use condoms - Consistent condom use reduces the risk of STDs and STD-related fertility problems significantly. In one study, women who reported regular use of condoms were 60 percent less likely to become infertile. Until you're ready to start trying to conceive, use a condom every time you have vaginal, anal or oral sex. For vaginal sex, use a latex male condom or a female polyurethane condom. For anal sex, use a latex male condom. For oral sex, use a dental dam.

• Educate yourself - Be aware that some methods of birth control, such as birth control pills, shots, implants and diaphragms will not protect you from STDs. If you are using one of these methods and are not in a monogamous relationship, use a condom every time you have sex.

• Have regular pelvic exams - Doctors usually recommend a routine Pap smear once every year until you've had at least three normal ones. After this, you should have a Pap smear at least once every three years, unless your doctor thinks you need them more often. Ask your doctor to test you for gonorrhea and other STDs during your routine Pap smear. The sooner an infection is found, the easier it is to treat.