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    Can some STIs make you infertile?

    On this page
    1. Which STIs cause infertility?
    2. Chlamydia & gonorrhoea
    3. Risk of infertility from untreated chlamydia 
    4. Risk of infertility from HIV
    5. Which STIs cause pregnancy complications?
    6. How are fertility complications caused by STIs treated?
    7. Can infertility caused by STIs be reversed?
    8. How to prevent infertility from STIs

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    There are several different sexually transmitted infections which are common in the UK, including chlamydia. Most don’t pose any serious threat to your health as long as they’re diagnosed early and treated, but some can cause complications if they go untreated. In rare cases, an untreated STI can cause problems with your fertility.

    The problem is that some STIs don’t cause any symptoms at all, which means it’s not always possible to know that you’re infected without a test. 

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    Which STIs cause infertility?

    Chlamydia & gonorrhoea

    Chlamydia and gonorrhoea are both bacterial STIs which are treated with antibiotics. Left untreated, however, they can cause fertility issues in women and possibly in men . 

    In women, untreated chlamydia or gonorrhoea can spread to the womb, ovaries or fallopian tubes, causing pelvic inflammatory disease (PID ). In men it can cause epididymitis - an inflammation of the tube that stores and transports sperm from the testicle. In England in 2020, about 0.6% of chlamydia cases led to PID or epididymitis.

    Not only can PID cause chronic pelvic pain (that is ongoing pain in your lower tummy), it can also make it difficult for you to get pregnant. This is because the infection can lead to scarring and blockages in the fallopian tubes, making it impossible for eggs to travel through.

    Risk of infertility from untreated chlamydia 

    How common infertility is, depends on lots of different things. In the UK it's thought that as many as 1 in 7 heterosexual couples will experience infertility. 

    Chlamydia can cause infertility - it tends to cause problems with the fallopian tubes (tubal factor infertility, TFI). The fallopian tubes transport the egg from the ovary to the womb. If the tube is blocked or the 'conveyor belt system' does not work well, the egg can’t travel to the womb and it will not be fertilised. 

    For men, the risk of infertility from untreated/ undiagnosed chlamydia is even more difficult to assess; it is not clear whether or how chlamydia infections contribute to infertility in men. What’s known is that chlamydia can affect the testicles and the tubes that store and carry sperm - it can also affect the quality of the sperm cells. 

    Risk of infertility from HIV

    HIV can make it more difficult to conceive. This might be due to the virus itself or because sexual behaviours have changed as a result of HIV. Many people who are living with HIV are worried that they might pass on HIV to their partner or baby. 

    HIV might be linked to early miscarriage, but HIV medication is not thought to cause problems for the baby. If you are affected by HIV and you are thinking about starting a family, you might find these articles helpful: 

    Which STIs cause pregnancy complications?

    Some STIs make it difficult to initially conceive, while others pose a risk while you’re pregnant. 

    Syphilis in pregnancy is particularly dangerous, as it can cause miscarriage, prematurity, stillbirth, neonatal death, low birth weight, or a serious infection in the baby. 

    Trichomonas (also known as “trich”) might cause your baby to be born prematurely or with a low birth weight. At this moment in time, we don’t know how big of an issue this is and more research is needed.

    Genital herpes can sometimes cause problems for the baby - this depends on whether you have recurrent genital herpes (this makes you low risk for problems during childbirth) or whether you caught it for the first time during the last six weeks of your pregnancy. If you caught herpes for the first time, your body hasn’t had enough time to make antibodies to protect the baby during pregnancy and childbirth. This means your baby can catch it during vaginal delivery. Your baby might get neonatal herpes, which is quite serious, but easily treatable. This is why some women are offered a caesarean section if it is certain that they got their first-ever genital herpes outbreak in the later stages of pregnancy. If you’ve had genital herpes outbreaks before you fell pregnant you may just be offered a course of suppression therapy to reduce the chance of an outbreak during labour. 

    How are fertility complications caused by STIs treated?

    If chlamydia or gonorrhoea cause PID or inflammation in the testicles or epididymis, this can be treated with antibiotics. You’ll usually need a 14-day course, which might involve having injections as well as taking tablets. 

    Syphilis and trichomoniasis can also be treated with antibiotics, but genital herpes requires antiviral medicine as it’s caused by a virus. 

    Can infertility caused by STIs be reversed?

    Women who are struggling to conceive because they have blocked or scarred fallopian tubes (due to chlamydia or gonorrhoea) may be able to have surgery to correct this. However, the success of the surgery will depend on how damaged your fallopian tubes are. 

    Another option is to have IVF (in-vitro fertilisation), as this doesn’t require working fallopian tubes. During this process, eggs are directly removed from your ovaries with a needle, and then fertilised with your partner’s sperm, before being transferred to your womb. 

    How to prevent infertility from STIs

    The best way to safeguard your fertility is to avoid getting an STI in the first place by practising safe sex. Infections like chlamydia and gonorrhoea can spread easily if you have unprotected sex, so make sure you always use condoms if there’s any risk your partner might have an STI.

    In addition to safe sex, it’s a good idea to get regularly tested for STIs – usually once a year. You can get free STI tests at sexual health/GUM clinics. Alternatively, you can order one of our home STI test kits from Online Doctor.

    Remember: STIs don’t always cause symptoms in their early stages, so it’s possible to have an infection and not realise. The only way to know for sure is to get tested.

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    References

    https://www.nhs.uk/conditions/chlamydia/complications/
    https://www.nhs.uk/conditions/gonorrhoea/complications/
    https://www.nhs.uk/conditions/syphilis/
    https://www.nhs.uk/conditions/trichomoniasis/
    https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-genital-herpes-and-pregnancy1.pdf
    https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
    https://www.nhs.uk/conditions/epididymitis/
    https://www.nhs.uk/conditions/infertility/treatment/ 
    https://www.nhs.uk/conditions/ivf/what-happens/
    https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1015176/STI_NCSP_report_2020.pdf 
    https://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables
    https://www.nice.org.uk/guidance/cg156/chapter/context

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