Skip to Site Navigation | Skip to Content

Mar2008

A Cause of Infertility Becomes More Common

A few weeks ago, news headlines blared the bad news: one in four American teen girls have a sexually transmitted disease.

What does this mean to a fertility specialist? What does it mean to women who want to get pregnant?

STD 101
A number of sexually transmitted diseases can silently cause tubal factor infertility, one of the more common causes of infertility in women. In fact, in vitro fertilization (IVF) was initially developed to treat tubal infertility, the result of scar tissue built up to the point of blocking the ovulated egg's path toward conception.

Bacterial infections like chlamydia and gonorrhea are common causes of tubal scarring. Syphilis can lead to very serious health conditions. Fortunately, bacterial STD's can be cured with relative ease through oral or injection antibotics. All of them are highly contagious, spread with relative ease even from physical intimacy without penetration.

Chlamydia and gonorrhea, particularly, can do a lot of damage within a woman's body with little or not noticeable symptoms. The longer a woman has these diseases, the greater are the chances of her future fertility being damaged.

Are You At Risk?


Virtually any women who has had sex is at risk for exposure to STD's. Even if she's only had one partner in her life (which isn't a common situation,) chances are good that her partner has had more than one partner. Accordingly, women who've had more sexual partners are at greater risk.

It's relatively common for women to not know they've had an STD until they have difficulty getting pregnant. Their concerns are often confirmed with a diagnostic test known as the hysterosalpingogram (HSG). The HSG test allows us to view the patency of a woman's fallopian tubes by observing with ultrasound how well fluid flows through between the ovaries and the uterus. Scarring from STD related damage may partially or totally block fallopian tubes.

Tips for Reducing Your Risk


Don't assume you're fully informed about someone's health status by appearance only. Make getting tested for STD's a regular part of your health care routine, and expect the same of your sexual partners.

In addition to monogamy, the use of latex condoms with water-based lubricants is one way to lessen risk of STD exposure.

The Fertility Expert's Concern


In addition to the high incidence of STD-related tubal factor infertility, as a physician, I'm also concerned about my patients' overall health, the health of their future pregnancies and children (most STD's can be passed on to babies in utero or through the birth process), and the general public's health. For these reasons, we routinely screen our patients and their partners for HIV, syphilis, hepatitis, Chlamydia, and gonorrhea.

Another treatment-related reason for screening fertility patients: if the patient needs IVF to conceive, Federal regulations for the protection of human tissue prevent us from freezing infected samples, a precaution necessary for the safety of non-infected sperm or embryos.

Any patients who test positive for STD's will be required to fully treat the condition before resuming fertility therapy. The impact on a patient's fertility of previous infection will vary, and fertility treatment recommendations will vary accordingly. For some patients, surgical correction of lesser tubal blockages may be followed by treatment with intrauterine insemination (IUI). In general, IVF is a very reliable workaround for even completely blocked and damaged fallopian tubes.

In Closing


In this day and age, there's no need for social stigma to stand in the way of your health or ability to conceive. STD's are bacterial and viral infections, not indicators of moral judgement. My staff and I welcome your questions about all of your fertility and reproductive health concerns.

Sincerely,

Sonja B. Kristiansen, MD