Sexually Transmitted Diseases (STDs) have become a pressing issue for public health concern, with a staggering 20% of women suffering from infertility due to Pelvic Inflammatory Disease. The transmission of STDs or sexually transmitted infections (STIs) can occur through sexual contact between individuals. PID results in scarring of the reproductive organs, including the cervix, vagina, ovaries, fallopian tubes, and uterus. If left untreated, PID can cause permanent damage and infertility, particularly contributing to infertility caused by tubal factors.
Dr Anviti Saraf, IVF Specialist, Nova IVF Fertility, Noida, says, “Chlamydia and gonorrhea are the most common sexually transmitted infections. The American Society for Reproductive Medicine (ASRM) states that tubal factors account for 25-35% of female infertility. When the fallopian tubes are damaged or obstructed, infertility can occur in two ways: by hindering the sperm’s ability to reach and fertilize the egg, and by preventing a fertilized egg from traveling to the uterus for implantation and pregnancy.”
How do STIs cause infertility?
STIs can cause both male and female infertility. In women, an untreated STI can cause inflammation and tubal blockage, making it difficult for the sperm to reach an egg. Even if the egg and sperm meet up to form an embryo, there is a high chance of embryo implanting in the tube leading to Ectopic pregnancy. An unrecognized ectopic pregnancy can be fatal as it may rupture the tubal walls and cause life-threatening bleeding.
“STIs may also damage the endometrium which is the lining of the uterus by causing endometritis. This may cause thinning of endometrium and impair blood flows within it, subsequently leading to implantation failure,” adds Dr Saraf.
Females under the age of 25 are also more likely to develop Pelvic Inflammatory Disease (PID) than those over the age of 25. The reason for this is that the cervix of girls under the age of 25 is not fully prepared to fight Sexually Transmitted Disease, which leads to PID. In men, an untreated STI can cause fertility issues by damaging and blocking the epididymis, a long tube that transports sperm from the testes to the urethra.
Chlamydia
Untreated chlamydia can harm and scar the uterus or fallopian tubes in women, making pregnancy less likely. According to recent reports, if chlamydia is not treated, 10%-15% of women develop PID. Chlamydia can deteriorate the quality of men’s semen and sperm health, resulting in male infertility.
“While chlamydia and gonorrhea are easily treated with antibiotics, people may be unaware of infection with these bacteria due to the lack of any visible symptoms. Unfortunately, the longer the infection goes untreated, the greater the risk of potential damage. Women who do experience symptoms (roughly 25%) may experience abdominal and/or pelvic pain, spotting, and unusual discharge,” opines Dr Saraf.
Gonorrhea
Anyone who is sexually active can contract gonorrhea. Gonorrhea can grow in a female’s reproductive tract, particularly the uterus and fallopian tubes, resulting in PID and tubal factor infertility. In males, gonorrhea can cause epididymitis, or inflammation of the ducts. If left untreated, gonorrhea can lead to male infertility by clogging the duct and preventing sperm from entering the female during intercourse.
Syphilis
Syphilis is caused by a bacteria Treponema Pallidum, that is typically transmitted during sexual contact. However, coming into contact with a syphilis sore is another way it can be transmitted. If left untreated, syphilis can be passed to the next generation.
“Although syphilis has no direct effect on male fertility, it can cause complications that can lead to epididymitis. Scarring in the sperm ducts caused by this disorder can prevent sperm from being released during ejaculation. It may also affect peripheral nerves causing their degeneration and subsequently erectile dysfunction,” states Dr Saraf.
In its early stages, syphilis can be cured with penicillin, an antibiotic medicine that can eradicate the causative organism. The recommended treatment for syphilis includes a single injection of penicillin, though for some people additional doses may be necessary.
Human papillomavirus (HPV)
According to recent studies, HPV is the most primarily transmitted skin-to-skin infection, causing warts on the skin and in the genital area. It can take a long time to treat these warts, which can disrupt a couple’s sexual relations.
Some HPV strains increase a woman’s risk of developing precancerous and cancer cells in the cervix, vagina and vulva. The removal of cancerous and precancerous cells from the cervix has an impact on fertility. The procedures used to remove these cells can alter cervical mucus production, affecting a woman’s ability to conceive. Some HPV types in males cause persistent infection and progress to genital cancers that impair fertility.
Herpes simplex virus (HSV)
Herpes simplex virus (HSV) is a sexually transmitted infection that most commonly affects a large array of population and manifests as small blisters on the genitals. If a woman in her pregnancy contracts HSV, there is a high possibility of transmission of the virus to the baby during vaginal delivery. The effects of HSV on the baby could be fatal. HSV can affect fertility indirectly by causing a couple to avoid sexual contact during outbreaks, lengthening the process of trying to conceive.
However, certain antiviral medications aid in the treatment of sores and other symptoms.
Treatment and Prevention
Early detection can help to avoid complications. “If a person has STD, it is critical that they complete the course of medication in order to avoid reinfection and abstain from sexual intercourse till the infection is cleared. STDs can live in the body for years without causing symptoms, and therefore, it is crucial for all sexually active people to have annual screenings. Getting tested for infection is beneficial for both partners’ assurance. The most effective way to prevent PID is to use a method of contraception, such as a male or female condom, and to have regular sexual health check-ups,” signs off Dr Saraf.
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