Can STDs Affect My Ability to Have Children?

Sexually transmitted diseases (STDs) can affect your ability to have children. That's particularly true for women. Left untreated, even an asymptomatic STD can eventually lead to an episode of pelvic inflammatory disease (PID). PID is one of the leading causes of preventable infertility. Women with PID have scarring on their fallopian tubes and other reproductive organs. This makes it difficult for sperm to reach an egg. It can also lead to an ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg doesn't get to the uterus before implanting. An unrecognized ectopic pregnancy can be an emergency situation. 

STDs can also cause infertility in men. The process can be similar to how PID damages a woman's fallopian tubes. The structures of the male reproductive tract, including the epididymis and urethra, can be damaged by infection with an untreated STDs. Viral infections and immunodeficiency caused by HIV can also reduce semen quality in men. That makes it harder for them to get their partners pregnant. STD-related infertility is less common in men than in women. However, that is partially due to the fact that STD infections in men are more likely to cause symptoms. They are therefore more likely to be treated. 

A hysterosalpingogram is a picture of the uterus and fallopian tubes. The dye is injected through the cervix. Then the image is taken. This is used to detect any areas of the female reproductive tract that have blocked by scarring. If the dye can't get through, neither can a sperm or egg. This test is used to help diagnose infertility caused by PID and related processes. It can be quite uncomfortable.

There is extensive data showing that untreated chlamydia can lead to infertility in women. That's a big problem, as chlamydia infects more than 1.7 million Americans every year. How does chlamydia lead to infertility? It causes a large amount of inflammation (swelling) in the fallopian tubes. It's this scarring that can then block the tubes so that eggs can not travel to the uterus. This is known as tubal infertility because the problems originate in the fallopian tubes. Research suggests that chlamydia infections are responsible for close to half of all cases of tubal infertility in the developed world. There is conflicting evidence about what role chlamydia plays in male infertility.

Gonorrhea can lead to infertility in the same way as chlamydia. While not as common as chlamydia, it is still the second most common reportable disease in the United States. As gonorrhea can go undetected for long periods of time, tubal damage from the disease is common. Somewhere between 10% and 20% of women with gonorrhea have symptoms of pelvic inflammatory disease. Gonorrhea infections probably account for around 20% of PID cases in the US. Gonorrhea has also been shown to cause problems with sperm health in many men. Together, gonorrhea and chlamydia are the leading causes of preventable infertility both in the US and around the world. 

When women with PID have neither gonorrhea or chlamydia, they probably have mycoplasma. It wasn't until the 1980s that doctors discovered and learned how to detect this bacterium with any regularity. Now that scientists know how to find it, they estimate that it's even more common than gonorrhea. Mycoplasma infections have been associated with PID and infertility in women, although not as often as chlamydia or gonorrhea. There is also some evidence suggesting that mycoplasma may lead to reduced fertility in men. 

There is limited evidence to suggest that herpes may be associated with infertility in men. However, to date, there has been very little research on the topic. What research there is suggests that herpes infection may be associated with reduced sperm count. There is also evidence that the herpes simplex virus may make it harder for men's bodies to produce sperm. Finally, herpes viruses have been found inside of sperm cells. It is uncertain what implications the presence of herpes inside sperm cells has for establishing a successful pregnancy. 

HIV can cause biological changes which may affect the functionality of reproductive organs and result in infertility. Further, several HIV/acquired immune deficiency syndrome (AIDS)-related comorbidities, such as orchitis, acute epididymitis, and PID, are associated with infertility. There is also some suggestion that, like herpes, HIV can affect sperm health. HIV can also complicate the process of having children or undergoing fertility treatment. That's because, as a sexually transmitted virus found in semen, doctors want to be certain not to transmit the virus from one partner to another during insemination. That said, there are assisted reproduction options that can make having children when HIV positive much safer. HIV infection doesn't mean having to give up the dream of having a child of your own. 

It is important to note that most people infected with the aforementioned STDs will not become infertile. That is particularly true for those who are screened and treated appropriately. The STDs that cause infertility usually do so because of chronic, undetected infections.

The problem of unnoticed and untreated STDs causing extensive damage over time is one reason why STD screening is so important. Regular STD screening helps catch asymptomatic infections. Otherwise, these infections can go unnoticed, and untreated, for years. Screening and treatment aren't just important in slowing the spread of the STD epidemic, it also can help preserve a person's ability to have children.