How STDs can Harm Fertility (and what to do about it)

As if getting a sexually transmitted disease (STD) isn't bad enough, if you are trying to get pregnant, STDs can harm your fertility as well as your future baby. If people think their grandmothers (or worse their dads) giving sex advice is embarrassing enough, talking about STDs is a whole new level all together and likely to be incredibly uncomfortable. Since 1 in 4 Americans will develop an STD sometime during their lifetime,  this is a topic that needs to be addressed (source). Whether you have been diagnosed with an STD in the past or not, this is a conversation to have with your doctor at your preconception visit or annual physical. If you or your partner has a history of multiple sexual partners, it’s especially important for the both of you to get screened. Many STDs are asymptomatic (have no signs or symptoms) and since routine gynecological exams do not often test for all STDs, you could have one without even knowing it (source). For this blog post we review 7 STDs that can harm fertility and even cause infertility if left untreated and what can be done to protect you and your future baby. 

 

Gonorrhea 

Gonorrhea is a bacterial infection and while it may sound like some infection that only happens if you visit a far away jungle, gonorrhea can be contracted by any sexually active person.  It can be spread through oral, vaginal or anal sex.  The Center for Disease Control (CDC) recommends yearly gonorrhea screening for all sexually active women younger than 25 years, as well as older women with risk factors such as a new or multiple sex partners (source). 

Gonorrhea left untreated can result in ectopic pregnancies or spread to the uterus or fallopian tubes and may lead to Pelvic Inflammatory Disease (PID). PID is a term used to describe an upward traveling infection in women that can lead to infertility if not treated. PID can cause fallopian tube, ovarian and pelvic damage (source).

Since gonorrhea is a bacterial STD, it can be treated with antibiotics prescribed by your OB/GYNB.

 

Chlamydia

Chlamydia is a common STD that can infect both men and women. Many women do not know that they have it until they start trying to get pregnant and are unable to. Even though Chlamydia can be detected with a simple urine test and treated with antibiotics, it is often not screened for by doctors. If you have chlamydia, your partner should also be tested. There is a 25% reinfection rate in women believed to be due to the partner not being treated.  Similar to Gonorrhea, if left untreated, you can an experience an ectopic pregnancy or contract PID. PID can also cause infertility (source). 

 

Trichomoniasis

Have you ever heard of trichomoniasis? If not, trichomoniasis is actually a common parasitic infection and is one of the most common treatable STDs.  According to the CDC, 7.4 million new cases occur every year.  One recent study found that infection rates of trichomoniasis were found to be higher among women over the age of 40 than in younger women between ages 18 to 39 (source).  This may be due, at least in part, to the fact that the infection can be present without any symptoms.  Thus, the condition may not be diagnosed until it becomes more advanced.    

So it’s important that women who are planning their pregnancy should be screened for trichomoniasis, since it is easily treated with antibiotics prescribed by your OB/GYNB. This infection can cause fallopian tube damage. Women with this parasite are more likely to have their babies too early (preterm delivery). Also, babies born to infected mothers are more likely to have a low birth weight (less than 5.5 pounds) (source). 

 

Syphilis

The CDC recommends that all pregnant women get tested for syphilis (source).  Syphilis is a bacterial sexually transmitted infection that can cause serious complications if left untreated. It can cause you to have a miscarriage and is very dangerous for your baby if you have this infection while you are pregnant. Fortunately, syphilis can treated with antibiotics prescribed by your OB/GYNB.

 

Human Papilloma Virus (HPV)

HPV is the most common STD in the US. In fact, it’s so common that nearly all sexually active people get it at some point in their lives.  Fortunately, most cases of HPV may go away on its own. Most people with HPV do not know they are infected and never develop symptoms or health problems from it. There are many different types of HPV. Some types can cause genital warts and some strands of HPV that can cause cancer.

Currently there is not a test for HPV and the CDC does not have any screening recommendations (source). Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they’ve developed more serious problems from HPV, such as cancers (source).

You may have heard of the HPV vaccine. The vaccine is only approved to be given to women up to the age of 26. Why? A combination of reasons, mostly due to the fact that most women over the age of 26 will have already been exposed to the virus. To protect yourself from the potential negative consequences of HPV, you should get regular Pap smears (which you should continue to do even if vaccinated) (source).


If you have been treated for the cancer causing strand of HPV, your cervix may have been damaged while removing the cancerous cells. If you have warts from HPV, you will want to treat the warts to have them removed. If the baby gets HPV, warts can develop in the throat that will need to be surgically removed or they can cause complications during delivery (source). 

 

Herpes

Genital herpes is a chronic, life-long viral infection affecting approximately 50 million people in the US.  Many people have only mild or unrecognized infections, and as a result, the disease can be transmitted by people who are unaware that they have the infection.  Some studies have shown that a severe outbreak in the first trimester of pregnancy can result in miscarriage, but other studies have not shown this cause-and-effect relationship. Nevertheless, it is wise to ask you doctor whether or not they recommend that you be tested for herpes. 

While there is no cure, your doctor can give you oral medication to treat outbreaks when they occur and to suppress the likelihood of transmission (source). Also, if you have herpes, if your baby is treated immediately following birth, it will improve the chance of a healthy baby (source). 

 

Human Immunodeficiency Virus (HIV)

There is no cure for HIV but advances in medicine have significantly improved and prolonged the lifespan of people with this diagnosis. Antiviral medication can be given to reduce symptoms during pregnancy and to prevent transmission to the baby. Breastfeeding can transfer the disease to the baby, and therefore, should be avoided. 

 

Other STDs


According to the CDC, the highest rate of infection occurs among those 20 to 49 years old is Hepatitis B (HBV). The CDC recommends that all women get tested for HBV at their first prenatal visit.  Your partner should consider it as well since it has been shown to decrease sperm mobility in males (source). HBV has a vaccination and you should check your vaccination records to see if you have received it. You may also be screened for Hepatitis C (HCV) if you are at risk. 

 

Additional References:

  • https://www.babycenter.com/0_preconception-checkup-why-you-need-one-and-what-to-expect_730.bc
  • https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/symptoms-causes/syc-20351240
  • https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/20/50/preventing-mother-to-child-transmission-of-hiv
  • https://www.cdc.gov/std/pregnancy/stdfact-pregnancy-detailed.htm