The Link between STDs and Infertility.
Date: February 18th, 2022
Infertility is a serious public health concern globally. It is defined as being unable to get pregnant after one year, and it is a painful experience for most couples. In the U.S alone, around 9% of men and 11% of women have infertility.
In some instances, sexually transmitted diseases also referred to as sexually transmitted infections, can increase the chances of infertility. And this is specifically true in women than men.
This article will look into the link between STDs and infertility, discussing specific ones that directly affect the reproductive system.
Sexually transmitted diseases, STDs and infertility.
If left untreated, even sexually transmitted diseases that do not show symptoms can cause pelvic inflammatory disease, which is one of the primary causes of preventable women infertility. Women suffering from PID have scarring in the reproductive system, especially the fallopian tube.
The scarring makes it hard for the sperms to reach eggs for complete fertilization. They can also lead to ectopic pregnancy. This type of pregnancy happens when the fertilized egg does not reach the uterus and implants itself along the fallopian. If left unnoticed, ectopic pregnancy can be a medical emergency.
Also, sexually transmitted diseases can cause infertility in men. The procedure leading to men's infertility follows the same manner how PID damages women's fallopian tubes. The untreated STD can affect the male reproductive system by blocking structures like the urethra and epididymis.
Also, the immunodeficiency and viral infections from HIV/AIDs can reduce the semen quality in men. Though low sperm quality can be treated under varied circumstances, making it hard to make a woman pregnant.
Surprisingly, one-third of infertility issues are linked to women, one-third men, and the remaining third to other factors like age and health conditions. Unfortunately, sometimes some couples do not find the cause of their problem. It always remains a mystery.
Besides being unable to get pregnant, miscarriages and stillbirth are all in the infertility-related category, all of which are traumatic losses.
As studies have shown, there are several types of STDs causing infertility that have been studied for a long time now. In this section, we look at these sexually transmitted diseases in detail.
Types of STDs causing infertility.
Chlamydia is the most common type of sexually transmitted infection reported in the U.S. It is caused by a bacteria called chlamydia trachomatis.
Chlamydia is transmitted through unprotected vaginal, oral, or anal intercourse. Also, you can contract it when you get into contact with an infected person's semen or genitals, even without having sex. A pregnant mother can also transmit it to her baby during childbirth.
Although it does not cause infertility on its own, it is estimated that around 40% of women with this infection develop the pelvic inflammatory disease. The disease affects the reproductive system including, fallopian tubes, ovaries, and uterus, always resulting in infertility.
Signs and symptoms of chlamydia.
Usually, chlamydia does not show symptoms; therefore, it is difficult to say you have the disease through visual examination. This is the reason it is called silent infection.
But because the infections can cause lead to some serious and permanent damage to the reproductive system, it is vital to identify and treat them earlier. One of the common chlamydia manifestations is the infection of the cervix, resulting in a burning sensation in women called cervicitis..
Though chlamydia rarely shows symptoms, when they do, they are often mild and start appearing a few weeks after the infection. It can sometimes include abdominal pain or vaginal discharge as symptoms in women.
Prevention tips and treatment options of chlamydia.
Frequent use of protection such as dental dams and condoms each time you are having sexual intercourse of any kind is necessary to prevent contracting chlamydia. However, keeping a monogamous relationship is the surest way to prevent the infection.
Luckily chlamydia is treatable with antibiotics prescribed by a certified sexual health professional. Antibiotics may be prescribed as a single dose or a seven-day course treatment.
Women are required to refrain from sex for the seven days of treatment or seven days after the single dose to prevent the infection from spreading further or reoccurring after treatment.
Doxycycline and erythromycin are some of the most prescribed antibiotics for the treatment of chlamydia. Apart from doxycycline, all other medications can be used to treat pregnant mothers safely without interfering with the growing fetus.
All your sexual partners also need to be tested for chlamydia to prevent the risks of reinfection and reduce the spread of the disease.
This is another one of the most prevalent sexually transmitted diseases among young people of both genders between 15 to 25 years. Depending on the mode of transmission, the infection affects the vagina, throat, and rectum.
People can contract the disease through unprotected vaginal, oral, and anal sex with the infected person. Also, pregnant mothers can transmit the infection to their babies during childbirth. They can cause serious health problems to the child later in the years.
Similar to other STDs causing infertility, Gonorrhea is treatable with antibiotics, but if left untreated for long, it can spread in the female reproductive organs, including the uterus, ovaries, and fallopian tube. The vaginal inflammation leads to scarring of the uterine walls and fallopian tube, which further inhibits conception.
Gonorrhea symptoms in women.
Mostly, women suffering from Gonorrhea rarely show symptoms. When they occur, they are usually mild and can easily be mistaken for other vaginal infections.
Even if they don't show symptoms, women with Gonorrhea have high chances of developing serious medical complications. The following are the common symptoms you’ll see in women;
- Burning or pain during urination.
- Brown Vaginal discharge during periods.
- Increased vaginal discharge.
Symptoms of rectal infection in both men and women may include the following;
- Anal inflammation.
- Bleeding and painful bowel bleeding.
Symptoms during the periods can lead to severe menstrual cramps. It is essential to go for STD screening if you have any of the symptoms above. That feeling you may think as a simple inflammation may be a telltale sign of gonorrhea infection.
Human Immunodeficiency Syndrome, HIV, is a virus that invades the body's immune systems. If neglected, it can lead to AIDs, Acquired Immunodeficiency syndrome.
Currently, there is no cure for HIV. Once you contract it, you'll live with it for the rest of your life. However, with proper management and care, the disease can be controlled and allow patients to live a long and healthy life, keeping their partners safe.
The only sure way of knowing if you have HIV is through testing. Apart from making healthy life decisions, HIV testing also helps you avoid transmitting the infection to others or getting re-infected.
Symptoms of HIV infection.
Some people will experience flu-like symptoms during the first 2 to 4 weeks after getting infected with HIV, with the signs lasting for a few days or weeks. The common HIV symptoms include;
- Muscle aches.
- Sore throats.
- Night sweats.
- Mouth ulcers.
- Swollen lymph nodes.â€‹
Some people will not feel sick during this stage. Because these symptoms may not necessarily mean you have HIV as another disease can also show these signs, it is important to get tested if you suspect you have been exposed to the disease.
Stages of HIV.
When people with HIV do not get tested and treated immediately, they usually develop into three stages. However, effective and early medication can prevent the progressions to other stages. Let's look at the different stages of the infection below;
a. Acute HIV infection stage.
In this stage;
- People show a high amount of the virus in their systems and are highly contagious.
- Some patients may not feel sick straightaway.
- Other patients will show flu-like symptoms, which is the body's natural reaction to infections.
- If you got flu-like signs and suspects exposure to HIV before, then seek immediate HIV screening and medication.
- Remember, only nucleic acid tests, NATS, or antigen tests can be used to test HIV at this stage.â€‹
b. Chronic HIV infection stage.
This stage is also known as the asymptomatic stage. The virus is still active but replicates at a low pace. The following are what happens at this stage;
- People may not show symptoms or feel sick.
- Without effective medication, this stage can last more than a decade. Some may advance faster, and you can easily transmit the infection at this stage.
- At the end of this stage, the viral load or amount of the virus in the blood goes up, and the CD4 cell reduces. As the virus increases in the system, patients may start showing symptoms, moving them to phase three of HIV infection.
- Those who get treated immediately at this stage may not progress to stage three.
c. Acquired Immunodeficiency Syndrome, AIDs.
- This is the most severe phase of HIV infection. And those at this stage have a badly compromised immune system so much that they are prone to opportunistic infections.
- You can receive an AIDs diagnosis when your CD4 cells have reduced to 200 cells/mm, or when they start contracting different severe illnesses.
- Patients with AIDs have a high amount of viral load and are very infectious.
- Without proper and prompt treatment, people at this stage can only survive up to three years.
How HIV can lead to infertility.
As one of the listed STDs causing infertility, HIV causes biological changes to the body, which affects the reproductive systems leading to this unfortunate couple problem. Additionally, some HIV-related comorbidities like epididymitis, PID, and orchitis are linked to infertility.
There are various suggestions like herpes, HIV which can interfere with sperm quality hence causing difficulty conceiving. Furthermore, this infection can compromise the process of infertility treatment or attempts to make babies.
This is true since the virus lives in semen. Doctors may find it hard to prevent the transmission of the virus during the insemination process. Having said that, there are other options you can use to successfully and safely have children when living with HIV.
4. Mycoplasma Genitallium.
Usually, when women have Pelvic Inflammatory Disease, PID has Mycoplasma. So, what is Mycoplasma?
Mycoplasma genitalium is one of the bacteria that can cause sexually transmitted diseases. You can contract it when you engage in any form of sexual engagement, including touching and kissing with an infected person.
Scientists discovered this bacteria in the 1980s, and a recent study showed that 1 in every 100 people might have the bacteria.
Symptoms of mycoplasma genitalium.
Like the other STDs causing infertility like chlamydia, Mycoplasma does not show symptoms; therefore, it is possible to have the bacteria and not know about it. However, be on the lookout for the following signs;
- Stinging or burning sensations when peeing. Watery discharge from the penis.
- Pain or bleeding after sex.
- Discharge from the vagina.
- Pain in the pelvic region below the belly.
- Excessive bleeding between menses.
Unlike most STDs causing infertility, this bacteria does not have FDA-approved test procedures. However, when your doctor suspects you have the bacteria, he can recommend a nucleic acid test.
During the test, you'll be required to provide a sample of your urine. Also, the doctor can have a swab from the vagina, urethra, or cervix for more comprehensive test results.
Health complications from Mycoplasma that leads to infertility.
MG causes many health complications that can lead to or encourage the difficulty of conceiving. Here are some of these problems;
- A condition that causes the urethra to swell, irritate and itch. This problem is known as urethritis and can affect both men and women. Because the urethra is the pipe that transports sperms, any blockage prevents the sperms from flowing hence hindering fertilization.
- It causes the development of PID, which is the primary cause of most preventable infertilities in women. PID affects the female reproductive organs such as the fallopian tube, uterus, and ovary causing scarring in the vaginal walls leading to many complications like ectopic pregnancy and infertility.
- An inflamed cervix, known as cervicitis.
Though there is no conclusive evidence if this bacteria can cause impotence in men, it can make it hard to make babies when you have its symptoms, such as the swollen urethra.
While there is not enough evidence about the possibility of herpes causing infertility in men, a few studies have shown it can impact the fertilization process due to the quality of the sperm produced.
Herpes is a condition that results from the infection of the herpes simplex virus. It causes blisters and sores to appear around the genitals and mouth.
There are two types of herpes; oral, also called HSV-1, and genital, also known as HSV-2. This infection does not have a cure, but treatment can help manage its symptoms and prevent chances of recurring.
Symptoms of genital herpes.
Genital herpes develops as sores around the penis, inside, on the rectum, or around the vagina, though they can appear on any body part. Herpes can also cause changes in vaginal discharge and pain when urinating.
Immediately after the first outbreak, which usually lasts 2 to 6 weeks, the symptoms may reappear more often but reduce gradually.
What researchers suggest is that herpes is closely linked to low sperm count complications because the virus makes it difficult for men to produce sperm.
Lastly, the virus has been found inside semen. However, it is uncertain what effects this can have on infertility.
Understanding tubal patency/HSG as tests of infertility in women.
As a woman who is trying to conceive, you probably understand that some parts of your body must work in sync. For instance, your ovaries must produce eggs monthly, fallopian tubes must be open, and the uterus needs to be in good shape.
If one or all of these organs do not function correctly, you might have difficulty getting pregnant. For example, if you have blocked fallopian tubes, sperms won't reach the eggs quickly, hindering fertilization.
Several reasons can cause fallopian tubes to block; however, regardless of the reasons, a doctor will perform a tubal patency test, also known as a hysterosalpingogram.
What is tubal patency test/ HSG?
This is a standard radiological imaging procedure used to confirm if the fallopian tube is opened or closed and free from diseases. This is usually a minor medical operation that lasts less than 10 minutes, and you are allowed to go home the same day.
Usually, the procedure is performed in the first ten days of the menstrual cycle. This strict timing and the use of birth control methods may sometimes make the fallopian look blocked while it is patent.
This test involves using a special type of X-ray that inserts an iodine dye through the cervix to the uterus and the fallopian tube while running transvaginal ultrasound.
The ultrasound allows doctors to see how the dye is flowing into the uterus up to fallopian tubes. If there is blockage at any point in the tube, the dye will struggle to pass around that area.
Why is the HSG tests common?
This test is commonly done on women who have pregnancy problems like multiple miscarriages or are diagnosed with infertility. HSG can help diagnose if the cause of fertility is a blocked fallopian.
Also, if you have undergone tubal surgery, the doctor can recommend hysterosalpingography to confirm whether the operation was successful. This test can also be used to check if your tubes are connected perfectly after undergoing tubal ligation.
The meaning of tubal patency test results.
The HSG test allows the doctor to check two factors.
- If the fallopian tubes are opened or blocked, a blocked fallopian tube does not allow passage of sperms to reach the eggs, hence reducing the chances of conception.
- Whether the shape of the uterus is normal or not; around 10 to 15 women experiencing recurrent miscarriages have an abnormal uterus shape. Some of such abnormalities can be corrected by surgery.
If the X-ray displayed the dye flowing freely and the uterus shape is correct, then the results are considered normal. However, this does not mean your fertility is entirely normal. It only indicates that whatever may be the problem is not shown on HSG.
Though all procedures have risks, HSG is safe. You may only experience problems if you are allergic to the chemicals used in the dye. Injury to the uterus or pelvic infections is also possible.
It is advised that you seek immediate medical care if you start feeling serious complications after a tubal patency test.
There are a lot of STDs causing infertility, especially in women. Sexually transmitted infections affect the reproductive organs such as the uterus, cervix, urethra, vaginal walls, and fallopian tubes.
Women infected with STDs develop scarring in the vaginal walls and extend to the fallopian tubes, where they swell and block the tubes. The inflammation and blockage of the fallopian tubes make sex a painful experience and prevents the sperms from fertilizing the eggs.
Some STDs causing infertility like Chlamydia and Gonorrhea can be cured with the proper treatment, while others like HIV and herpes can only be managed with appropriate medication and the right lifestyle choices.