STDs and Tubal Factor Infertility

STDs are a fact of life but they don’t have to be a factor in infertility, if diagnosed and treated adequately

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It is currently estimated that about 75 percent of women will acquire one or more sexually transmitted diseases (STDs) during their lifetime. Some STDs can affect fertility in men and women.

These diseases are caught from sexual contact with another person who is infected with an STD, which are most common in young adults under 25 years of age. STDs are the most common cause of tubal factor infertility, which accounts for about 30 percent of female infertility in the United States. And they can be challenging to treat.

Sometimes STDs go unnoticed because there may be no symptoms. Yet these infections, especially when untreated, can lead to irreversible scarring of the fallopian tubes that impairs the ability to get pregnant and have children.

STDs include infections caused by:

  • Gonorrhea (Neisseria gonorrhoeae)
  • Chlamydia (Chlamydia trachomatis)
  • Trichomonas
  • Human papilloma virus (HPV)
  • Herpes simplex virus (HSV).

Chlamydia and gonorrhea infections have been shown to be associated with tubal factor infertility and pelvic inflammatory disease (PID). Both symptomatic and asymptomatic PID can cause permanent injury to the fallopian tubes.

STDs affecting fertility

Gonorrhea and chlamydia can cause inflammation of a woman’s cervix or inflammation of her urethra. Symptoms, if present, include a burning feeling during urination, abnormal vaginal discharge, and vaginal spotting. If not treated, anywhere from 10 to15 percent of these chlamydia infections will cause infection in the uterus or the fallopian tubes. Most cases of tubal factor infertility are attributable to untreated STDs that travel up along the reproductive tract and cause tubal inflammation, damage and scarring.

Cases of asymptomatic PID are also associated with decreased subsequent fertility, even in patients who are treated for chlamydia and gonorrhea. The prevalence of infertility after acute PID depends upon multiple factors, but appears to be increased several-fold.

Other STDs such as HSV, trichomonas and HPV do not affect fertility but have other side effects. The biggest detriment that herpes will have on a couple’s fertility is the need to abstain from intercourse during an outbreak in either partner. This can limit their chances of conceiving, depending on how long the outbreak is and how often they experience them.

HPV infection can cause genital warts (condylomas) that can be challenging to treat, sometimes taking months and years. Certain high-risk types of HPV have been linked to development of cervical cancer. Trichomonas infection is generally not thought to affect fertility. However, an untreated infection has been linked to preterm labor.

How do I know if I have been infected by an STD?

Screening for STDs is easy and inexpensive. Screening usually involves testing a urine sample (for gonorrhea and chlamydia), cervical swab (for trichomonas), Pap smear (for HPV), or a direct swab from a lesion (for a new HSV infection). If you have any symptoms or had unprotected sex with a new partner, get an STD test. The earlier STDs are diagnosed, the less likely they are to negatively impact your fertility.

Diagnosis of tubal factor infertility is typically done with a hysterosalpingogram (HSG) or laparoscopy.

Request an appointment to discuss STDs and infertility