The link between STIs and infertility
MOST sexually transmitted infections (STIs) can be treated with medication. But sometimes when left untreated, they can have serious reproductive health consequences, among them being infertility.
“Infertility is the inability of a couple to conceive after a year and a half of trying to get pregnant, and can be a source of major distress. It is one of the most common reasons for women to visit their gynaecologists,” says Dr Keisha Buchanan, obstetrician-gynaecologist at ICON Medical Centre.
She says the condition which affects both sexes can be caused by any number of things, but an increasing number of cases have been linked to STIs. These can spread to the womb and to the Fallopian tubes in women, and in men, up along the urethra (through which urine emerges) and the epididymis (the passage where spermatozoa travel from the testicles to the penis).
“The infections cause inflammation and scarring in the pelvic organs in women, such as in the Fallopian tubes and the lining of the womb — a condition called Pelvic Inflammatory Disease. This blocks the passage of the egg so that it cannot meet and be fertilised by the sperm. In men, inflammation of the epididymis and urethra causes scarring and blocks the passage of sperm. This causes the sperm count to fall off,” Dr Buchanan explained.
She said among the list of STIs that may cause infertility are chlamydia, which is the most common, gonorrhea, trichomoniasis, mycoplasma and ureaplasma. Others such as HIV, hepatitis B and C and herpes, however, carry their own set of risks but do not cause infertility.
She said that people should always investigate their sexual health, especially if they suspect that they could be carrying an infection. She acknowledges, however, that this can sometimes be hard to detect since most of these STIs are subtle and tend to be asymptomatic. This means that whichever party has the infection may not notice any problems, and so may be unaware that they need to get treatment.
“Symptoms in women may present with a watery, milky or yellow vaginal discharge, a blood-stained vaginal discharge, pain in the lower abdomen, pain during sex, fever, symptoms similar to a urinary tract infection — such as burning while urinating and passing the urine too often; while in men you may also see a watery, milky or yellow blood-stained discharge from the penis, pain in the testicles, groin pain, passing the urine too often, or burning during the passage of urine,” Dr Buchanan shared.
In cases where oral sex is practised, soreness in the throat or a discharge in the throat may be present.
Fortunately, however, Dr Buchanan said that these potentially dangerous infections may be easily treated once they are discovered early.
“These infections can be treated with antibiotics; however, the longer the infection is present and is untreated, the greater the chances of damage to the reproductive organs, and thus the likelihood of infertility problems. When some patients do get tested and discover that they have chlamydia, the infection could have already been present for several months,” she said.
Dr Buchanan advised that it is always best to use a condom, to have one sexual partner, or to abstain in an effort to protect yourself against these infections. In the event that you have unprotected sex or sex with multiple partners, Dr Buchanan recommends that you get tested for STIs. She warns against relying on the onset of symptoms alone, because this may be misleading.
“It is important to note that most people who get these infections and are treated will fully recover and will not become infertile. Along with STIs, there are other causes of infertility, such as hormonal imbalances in men and women — fibroids and womb polyps in women, and in men, factors that decrease sperm production such as an excessive exposure of the testicles to heat, cigarette and marijuana smoking.”
