There’s a hidden cause of fertility trouble that you don’t hear about very often: sexually transmitted diseases. You might be thinking, who me, STDs? I’m in a committed relationship! We’re trying for a baby! Isn’t that basically the polar opposite of the frat-partying, alcohol-drinking kids who need to worry about STDs?
Well, when it comes to STDs, not quite.
It’s true, the focus on STD prevention is mostly aimed at young people. But even if you haven’t slept with a new partner in years, it’s worth ruling out a hidden STD if you’re having trouble conceiving. So-called “silent” STDs can lie dormant in your body for years, causing symptoms so mild you might not even notice them, but wreaking havoc on your reproductive system.
The two big ones to know about are chlamydia and gonorrhea—they’re common, they often go unnoticed, and they can lead to pelvic inflammatory disease, which doubles your risk for infertility. According to the Centers for Disease Control and Prevention, last year there were more cases of chlamydia and gonorrhea than any illness, ever—and the majority of women infected with them will show no symptoms.
Chlamydia is the most frequently reported bacterial infection transmitted in the US. In 2014, 1,441,789 cases of chlamydia were reported to the CDC, but it’s estimated that there are 2.86 million chlamydia infections annually. Most cases are never reported because the majority of those infected show no signs of illness at all.
The 30 percent of infected women who do show symptoms may experience pelvic pain, spotting, and unusual discharge. When chlamydia is identified, it can be easily treated with antibiotics. But since so many women don’t realize they have chlamydia, it often goes untreated.
Insidiously, even when a woman no longer tests positive for an active chlamydia infection, the bacteria may move from her cervix into the upper genital tract and set off pelvic inflammatory disease (PID).
As with chlamydia, gonorrhea is a common STD that often causes no symptoms. When symptoms are present, they are usually mild—spotting, discharge, and pain when urinating.
And just like gonorrhea, left untreated, it can lead to PID.
Pelvic Inflammatory Disease
PID can cause pelvic pain, or it can be completely asymptomatic. Either way, it often leaves behind inflammation and scar tissue that can block a woman’s fallopian tubes, preventing fertilization. If a pregnancy does occur, complications are common; as many as one in 10 post-PID pregnancies are ectopic.
After each episode of PID, fertility is reduced: 12 percent of women are infertile after a single PID episode, 25 percent after two episodes, and 50 percent after three or more episodes.
PID can even lead to endometriosis—a condition in which bits of uterine lining grow outside the uterus, causing pain and sometimes infertility. It can infect the uterine wall and cause miscarriages, and invade the ovaries and lead to early menopause.
PID can be treated with antibiotics, but severe scar tissue may need to be removed surgically before a woman can get pregnant or to resolve pelvic pain.
Screening for STDs is easy and inexpensive. If you’re sexually active, annual screening is prudent. 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.
And if you do have an STD, be sure that your partner is tested and treated, or he could re-infect you.
At Ava, our mission is to serve as a partner in women’s health, and one of the most important ways we can support women is providing education. We created Avaworld so that women could get evidence-based information about fertility, pregnancy, and the menstrual cycle, backed by real science.