How sexually transmitted infections can affect female fertility—and what you can do about it
This post comes from our director of education and partnerships here at Extend Fertility, Kristen Mancinelli, MSPH. It was originally shared over at Biem on their blog, The Sex Files.
You probably already know that getting checked and treated for sexually transmitted infections is an essential part of caring for your health—and the health of your partner(s). But if you’re a woman who wants to start a family one day (or you’re having sex with one), there’s another very important reason to keep up with your STI screenings: preventing female infertility.
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The most important thing to know about infertility caused by undiscovered and untreated STIs is just that—it’s preventable. The infections that can lead to infertility, namely gonorrhea and chlamydia, are among the most common and most treatable, so testing and treatment can prevent the complications that can damage reproductive organs and leave a woman infertile.
Chlamydia and gonorrhea are both bacterial infections spread through sexual contact that can affect both men and women and are some of the most common STIs seen by doctors; an estimated 2.86 million cases of chlamydia and 820,000 cases of gonorrhea occur annually in the United States. More often than not, an infected woman has no symptoms—but unfortunately, even asymptomatic infection can cause pelvic inflammatory disease, or PID. Doctors estimate that up to 40% of women who contract chlamydia or gonorrhea and don’t properly treat the infection will wind up with PID, and up to half of PID cases are estimated by the CDC to be caused by chlamydia or gonorrhea infection.
Here’s how PID happens: when a woman is infected with one of these STIs, microorganisms can travel upward from her cervix or vagina to the other reproductive organs, causing them to be infected, as well. The PID, in turn, can cause scar tissue on the fallopian tubes that blocks the pathway of the egg released from the ovary, preventing natural pregnancy and causing infertility.
Even one episode of PID can cause irreversible damage of the reproductive organs, leaving 12% of women infertile. And because one occurrence increases the likelihood of another, women with a history of PID must be extra vigilant about STI screenings and gynecological check ups; multiple episodes significantly increase the risk of infertility, with 3 episodes bringing the rate of infertility to around 50%. Women with infertility caused by PID likely won’t be able to get pregnant without in vitro fertilization treatment, a technique that retrieves the eggs directly from the woman’s ovaries, fertilizes them in a lab, and transfers the embryos back to her uterus; IVF can overcome PID-related infertility by bypassing the scarred fallopian tubes.
PID can be treated with antibiotics, but treatment cannot reverse scarring of the reproductive organs once it’s already occurred—and it’s the scarring that can cause infertility. Alarmingly, pelvic inflammatory disease can present with mild symptoms or none at all (much like the STIs that can cause it). That means that women’s first and best line of defense against PID and preventable infertility is regular STI testing and quick treatment.
And for women who want to be proactive about protecting and preserving your fertility, egg freezing should be a serious consideration. Egg freezing involves retrieving multiple eggs from your ovaries and freezing them at very low temperatures (we’re talking -196ºC) in order to stop them from aging. If you freeze your eggs when you’re young and healthy, you’re effectively freezing time, allowing you to use your young, healthy eggs later in life when you’re ready to start a family. Along with regular testing and preventative care, it’s the best way to ensure you can keep all of your fertility options open.