Chlamydia and pregnancy

Dear Dr Mitchell,

I am 17 years old and I was diagnosed with chlamydia in January but I believe I had it for about two months before that. I’ve been trying for a baby with my most recent partner but haven’t been able to get pregnant. I’ve been tested again for chlamydia three times since I’ve been treated but they all came back negative. Could I please have some advice about my current problem?

Chlamydia is a sexually transmitted infection that can cause significant damage to the Fallopian tubes. It causes blockage of the tubes with inability to conceive. The infection can also damage the lining of the tubes resulting in an increase in probability of an ectopic pregnancy in the event that pregnancy does occur. In severe cases the Fallopian tubes, ovaries, lining of the uterus and cervix can become severely inflamed resulting in pelvic inflammatory disease (PID). This results in fever, abdominal pain, and sometimes a blood-stained malodorous vaginal discharge. It can also cause abscess formation in the Fallopian tubes and ovaries with subsequent severe chronic pelvic pain and extensive scarring.

The undersurface of the liver may also become inflamed causing pain in the right upper abdomen. Chlamydia may sometimes cause silent damage to the Fallopian tubes and ovaries with very few symptoms such as fever and pain. It frequently coexists with gonorrhoea especially when there is severe pelvic inflammatory disease. In this case there is the formation of purulent discharge (pus formation) in the Fallopian tubes, uterus and cervix. There may be associated painful urination, pain during sexual activity and associated fever.

Even though you were treated and subsequent swabs done were all negative, the damage to the Fallopian tubes could have already been done. Most couples will conceive within a year of regular, unprotected intercourse (two to three times per week). If you are concerned about the state of your Fallopian tubes, then you can do an X-ray called the Hysterosalpingogram (HSG). This will outline both Fallopian tubes and the uterine cavity, and will determine if the lining or the ends of the tubes are blocked.

It takes two to conceive. The problem might in fact be with your new partner. If you are in a serious, committed relationship, then you should have him do a semen analysis to determine if he is fertile too. This is a simple outpatient test that will help to demonstrate if he is the problem and therefore the need for his treatment.

Chlamydia is a serious infection and is transmitted by unsafe sexual practices, just like Human Immunodeficiency Virus (HIV), syphilis and herpes simplex II. It is important that you do a blood test to screen for these infections before attempting to become pregnant. This is a new union that you are now involved in and you should have your partner do all of these tests before having unprotected sexual intercourse with him. You might be opening up the potential for exposure to more sexually transmitted infections if you do this.

It is also important that you ask your doctor about the vaccine against the Human Papilloma Virus (HPV) that causes cervical cancer. Having sexual activity as a teenager increases your risk for cervical cancer. The vaccine is widely available and is recommended for all women aged 10 to 55. It is given in three doses — the first dose is followed by second dose one month later, and then the third and final dose given six months from the first dose.

You are still very young at age 17 and should probably focus on your college education and establishing yourself as an adult instead of focusing on trying to become pregnant. Enjoy your youth. There will be many opportunities to have a baby when you are older.

Best wishes

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver. com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax 968-2025. Dr Mitchell cannot provide personal responses.

DISCLAIMER: The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.