Sexually transmitted diseases (STDs), also known as sexually transmitted diseases or STIs, develop when bacteria, viruses, or parasites are passed during close contact. Most people become infected through unprotected lovemaking. However, these pathogens can also infect babies during pregnancy or childbirth.
STDs can not only affect overall health, but also affect fertility in the future. Depending on the type of pathogen and methods of treatment (or lack of it), they make it difficult to conceive or complicate pregnancy. STDs also pose a serious danger to the unborn child, and here’s why.
How STDs affect the ability to have children
These diseases seriously complicate the process of conception in both sexes, and in women — bearing, especially if they are not treated. Women are especially at risk of developing pelvic inflammatory disease (PID), which leads to scarring of the fallopian tubes and other important reproductive organs. In such cases, it is difficult for sperm to reach the egg.
These scars (adhesions) also increase the risk of an ectopic pregnancy, which occurs when a fertilized egg does not reach the uterus before implantation begins and implants outside of it. An ectopic pregnancy is life-threatening.
STDs can also affect male fertility. In particular, untreated diseases can cause damage to the epididymis and urethra. Viral infections and immune deficiencies associated with HIV can reduce the quality of sperm, making it difficult for an egg to be fertilized.
Since the symptoms of sexually transmitted diseases are more noticeable in men, they are more likely to receive therapy on time. And at the same time, due to the vagueness of the signs, these diseases often go untreated in women, which increases the risk of infertility.
Common STDs and their effect on fertility
In the group of such infections (and there are more than twenty of them), there is a significant diversity. Actually, they are united by the way of infection, but they affect the ability to have children in different ways. Let’s deal with the most common ones.
Human papillomavirus (HPV)
Scientists from the Southern California Reproduction Center have found that some women experience infertility problems if they become infected with carcinogenic HPV strains (the most dangerous are HPV 16 and 18 strains).
In some cases, they develop precancerous cells in the cervix that require medical removal. This can be done by one of three methods:
- a conical biopsy, which involves removing part of the cervix;
- cryosurgery, which freezes and destroys pathologically altered tissue;
- an electrosurgical removal procedure that removes precancerous cells and abnormal tissue using an electrically charged wire loop.
However, the scientists explain that while effective in preventing cancer, all three of these methods can make future pregnancy more difficult because they change or reduce the amount of cervical mucus, causing problems with sperm moving to the egg.
They also increase the risk of pregnancy loss because they can lead to cervical insufficiency. This increases the risk of dilating the cervix during pregnancy, which can lead to miscarriage or preterm labor.
Left untreated, chlamydia can cause inflammation in a woman’s fallopian tubes, leading to scarring that can block the tubes. This, in turn, prevents eggs from entering the uterus (tubal infertility).
A study published in the Journal of the Sexually Transmitted Diseases Association of America found that chlamydia is responsible for almost half of tubal infertility in developed countries.
Chlamydia is also dangerous for newborns. The Southern California Reproduction Center warns that half of babies born to mothers with this untreated condition develop chlamydial conjunctivitis, which can cause corneal scarring or blindness.
Gonorrhea can also cause tubal infertility, like chlamydia. This STI is responsible for approximately 10-20% of female pelvic inflammatory disease worldwide, according to a study published in Am Fam Physician.
Gonorrhea causes fertility problems in men as well. It can lead to a condition known as epididymitis, which occurs when the epididymis (the vas deferens) becomes inflamed. If the disease is not treated, it leads to scarring, which affects not only the transport of sperm, but also its quality.
Infants infected with gonorrhea develop gonorrheal conjunctivitis, which, like chlamydia, can cause blindness or corneal scarring.
Mycoplasma is a less common infection, but this does not detract from its seriousness. Like chlamydia and gonorrhea, it leads to pelvic inflammatory disease and subsequent infertility in women. A study published in Andrology also reports that mycoplasmosis is associated with male infertility.
There is no cure for genital herpes, experts warn, although it can be mitigated with antiviral drugs. But the virus itself, like other herpes viruses, remain in the body and become active at any opportunity convenient for them (more often against the background of other infections and a decrease in immune defense).
If earlier herpes viruses clearly «knew» where they should appear, and the two most common types — I and II — appeared only on the lips or genitals, today doctors observe a mixture of infections. So rashes of herpes on the lips with close contact can transmit the virus to other mucous bodies.
Although genital herpes does not usually affect a woman’s ability to conceive, it can harm an unborn baby. For example, if the virus is present in the birth canal, it is often transmitted to the baby during childbirth. This leads to neonatal herpes, a potentially life-threatening condition.
If syphilis is not detected and treated on time, there is a 50% chance that the pregnancy will end in miscarriage or stillbirth. Moreover, syphilis is easily transmitted to the baby through the placenta or during childbirth. This provokes congenital syphilis in a child, life-threatening.
In men, syphilis often leads to epididymitis.
Untreated syphilis also causes damage to other organs, from the face to the brain. In times when it could not be cured, tertiary syphilis with nasal involvement was so common that special masks or prosthetic noses were made for patients.
Human Immunodeficiency Virus (HIV)
Although HIV is not directly related to a woman’s chances of conceiving, it causes damage to internal organs, making it difficult to carry a pregnancy. One of the main risks of HIV is transmission from mother to child. However, if proper precautions are followed, including taking HIV medication during pregnancy, the risk of transmission is reduced to 1%.
We talk more about the problem of HIV, its prevalence in Russia and methods of anonymous testing in this article.
How to protect yourself from venereal diseases?
It is important to protect yourself from STDs. This includes the use of protection during lovemaking, and it is not protection against unwanted pregnancy. Not all contraceptives protect against infections. In fact, only condoms help, and even then not 100%. To protect against contact between the oral cavity and the genitals, the use of special latex wipes is recommended.
Various emergency prevention methods (urination after intercourse, organ washing with antibacterial drugs, the use of local antiseptics) help much worse than condoms.
In case of suspicion of infection, the best option is to quickly (during the day) contact a venereologist to prescribe prophylactic drugs.
It’s also important to get regular STD tests if you’re sexually active, whether you have the symptoms or not. In couples, this is recommended to both partners, regardless of the degree of trust, just as a preventive visit — the same as, for example, to the dentist.
Pregnant women are tested for STDs during pregnancy. But even before conception, regular screening is recommended to ensure overall health (and future fertility).
There are also ways to self-examine for such diseases. Read more about them in the article «Home tests for STIs.»
Remember, there is no shame in being infected, it is not a sign of promiscuity or a marginal lifestyle. But there is a danger of leaving the disease without treatment and then face extremely unpleasant consequences.
How much tubal factor infertility is caused by Chlamydia? Estimates based on serological evidence corrected for sensitivity and specificity. / Price MJ, Ades AE, Welton NJ, et al. // Sex Transm Dis. — 2012 Aug — 39(8)
Pelvic inflammatory disease. / Gradison M. // Am Fam Physician. — 2012 Apr 15 — 85(8)
The role of genital mycoplasma infection in female infertility: A systematic review and meta-analysis. / Tantengco OAG, de Castro Silva M, Velayo CL. // Am J Reprod Immunol. — Jun 2021 — 85(6)