Sexually Transmitted Infections and Conception

Sexually transmitted infections are responsible for a significant number of women struggling to conceive, or becoming infertile each year. STIs are often considered to be the 'silent causes', as they can often wreak havoc on a sufferer's health and fertility without their awareness, only to be discovered too late. But don't panic without real cause; here's our concise guide to understanding STIs in relation to your fertility. And most importantly, do not proceed with trying to get pregnant if you suspect that you have, or have had an STI, as they can have a very harmful effect upon your unborn baby.

Which diseases are we talking about?

HIV / AIDS, Herpes, Gonorrhoea, HPV (genital warts), Chlamydia, Syphilis, Hepatitis B and Trichomoniasis. Some of these diseases are communicable through anal or oral sex, not just vaginal sex, and so the use of a condom will not prevent their transmission. While the picture is less clear in the UK, figures from the US suggest that up to half the female population has had a STI, and that 15% of all women diagnosed as infertile will have the cause of their infertility linked to an STI.

Which STIs can impact on your chances of conception?

The biggest risk from STIs is not the infection itself, but the inflammation of the uterus and fallopian tubes that can spread unchecked as a result. This is often known as pelvic inflammatory disease (PID). Gonorrhoea and chlamydia are the diseases most likely to lead to PID, and in the long term the inflammation they cause can scar the fallopian tubes and hinder the passage of the egg through them. Generally, the other STIs are thought not pose a threat to conception.

Which STIS present a risk to you and the baby in pregnancy?

All STIs are capable of causing harm to you and your baby during pregnancy, even if they do not impact on your potential to fall pregnant in the first place;

• HIV/AIDS can be wholly passed on to your unborn child with severe consequences. Happily, there are drugs now available that can, in most cases, prevent the transmission of the disease to a baby.
• Herpes can be transferred to a baby during labour and birth, and so many women who suffer from this choose to deliver their baby by caesarean section.
• Gonorrhoea during pregnancy can increase the risk of miscarriage or premature delivery, and can cause blindness, joint infection or a life threatening blood infection in the new-born baby. All newborn babies are given eye medication at birth to prevent gonorrhoeal eye infections.
• HPV (genital warts) can pose problems during delivery if it causes blockages in the birth canal, thus sometimes infected mothers undergo caesarean section.
• Chlamydia can also increase the risk of miscarriage or premature delivery, as well as putting the newborn at risk of eye infections or pneumonia. The drug used to prevent eye infections also works against chlamydial eye infections, but the potential pneumonia is not preventable. As such, pregnant chlamydia sufferers are treated during pregnancy for the condition.
• Syphilis is a potentially fatal disease to babies and is easily transmitted during pregnancy. It often leads to premature delivery, and untreated babies who survive develop multi-organ issues. Pregnant syphilis sufferers are given treatment during pregnancy to halt transmission to the baby and their own worsening symptoms.
• Hepatitis B can be passed to the unborn child and increases the risk of a premature delivery. Newborns with mothers suffering from hepatitis B are injected with antibodies at birth to prevent them becoming infected.
• Trichomoniasis can also increase the risk of a premature delivery and can cause infection in the newborn.

What should you do before getting pregnant?

Firstly, be informed. Understand the impact that STIs may have both on your fertility and pregnancy. Proceed no further with trying to get pregnant if you have even a small suspicion that you have suffered from, or are suffering from, an STI. Symptoms of STIs include;

• vaginal discharge
• burning sensations
• itching
• painful urination
• bleeding between periods
• bumps, sores or warts near the mouth, anus, or vagina
• swelling or redness around the vagina
• weight loss, loose stools, night sweats

Secondly, it is wise for every woman wanting to get pregnant to have a health check with their GP, which will include checking for any symptoms, past or present, of STIs. And third, do all that you can to protect yourself from contracting STIs. Limit your number of sexual partners, and choose them with care, if you are not in a monogamous relationship. If you do have multiple partners, practice safe sex (yes, this is tricky when you are actively seeking pregnancy!), and limit your use of drugs and alcohol before sex, as they tend to impact on our decision making in relation to safer sex practices.