Sexually transmitted infections (STIs) are often discussed in terms of their immediate symptoms and transmission risks, but they can also have significant long-term health implications—including potential effects on fertility. Now, regardless of whether or not procreation is in your five-year plan, understanding these impacts is important for making informed choices about your health. Let’s explore how STIs can affect fertility, why early detection matters, and what steps you can take to protect your reproductive health.
In this article, we use the terms "male" and "female" to refer to sex and related reproductive anatomy. At Trusti, we acknowledge that sex and gender are distinct, and that intersex, Two-Spirit, transgender, and non-binary individuals may have diverse experiences and organ compositions that challenge traditional definitions. While we use these terms for clarity in discussing fertility, we recognize the limitations of normative language and strive to approach this topic with inclusivity and respect. We hope this framing allows everyone to feel seen and included in this critical conversation.
The Science of Fertility and STIs
Fertility refers to your ability to conceive and carry a pregnancy to term. STIs can interfere with this process in several ways, particularly when left untreated. Some infections cause inflammation and scarring, which can block or damage both male and female reproductive organs. Others disrupt the balance of healthy bacteria necessary for reproductive health.
Here are some common STIs and how they may affect fertility:
Chlamydia & Gonorrhea:
Chlamydia is one of the most common STIs, and according to the CDC, 10-15% of people with female reproduce organs with untreated chlamydia develop pelvic inflammatory disease (PID). PID can cause permanent damage to the uterus, fallopian tubes, and ovaries.Gonorrhea can also lead to PID and increases the risk of ectopic pregnancies. Don't worry if you don't know what PID is - we talk more about it down below.
In people with male reproductive organs, untreated chlamydia and gonorrhea can lead to epididymitis, (say that ten times fast), which can result in reduced sperm quality or blockages. Definitely not ideal conditions for your little swimmers.
Human Papillomavirus (HPV):
While HPV is more often associated with cancers (e.g., cervical, anal, throat), some studies suggest it may interfere with successful implantation of an embryo in the uterus.
Syphilis:
Syphilis is a bacterial infection that can cause complications during pregnancy, including miscarriage and stillbirth. Early stages of syphilis are treatable, so prompt action is critical.
Herpes Simplex Virus (HSV):
While herpes doesn’t directly affect fertility, active outbreaks during delivery can pose risks to the baby, making it an important consideration during pregnancy. It may not be as threatening as other STI's, but it’s definitely still something to consider.
Data on STIs and Fertility
Let’s put some numbers behind these risks:
CDC Statistics: According to the CDC, STIs are the most frequently reported infections in the U.S., with millions of new cases annually. Chlamydia and gonorrhea are leading causes of PID, which contributes to infertility in about 20% of cases.
Public Health Agency of Canada (PHAC): Chlamydia is the most commonly reported STI in Canada, with over 116,000 cases annually. The PHAC emphasizes that untreated infections are a major cause of preventable infertility.
Public Health Ontario: Ontario’s data highlights rising rates of gonorrhea and syphilis, stressing the importance of regular testing to catch infections before they cause irreversible damage.
How STIs Cause Fertility Issues
Pelvic Inflammatory Disease (PID):
PID is an infection of the female reproductive organs, often caused by untreated chlamydia or gonorrhea.
Scarring and blockages in the fallopian tubes can prevent eggs from reaching the uterus or sperm from fertilizing them.
Epididymitis:
Epididymitis is an inflammation of the epididymi, the coiled tube at the back of the testicle that stores and transports sperm. It can lead to blockages or reduced sperm quality.
Ectopic Pregnancy:
Infections can increase the risk of an ectopic pregnancy, where a fertilized egg implants outside the uterus. This is a life-threatening condition requiring immediate medical intervention.
Chronic Inflammation:
Some STIs cause persistent inflammation, disrupting the delicate balance needed for conception and implantation.
Prevention: The Best Practice
Prevention is key in reducing the spread of STIs. Here are some steps to minimize risk:
Use Protection: Consistent use of condoms and dental dams significantly reduces the risk of STI transmission.
Vaccinate: Vaccines for HPV and hepatitis B offer excellent protection.
Communicate: Open and honest discussions with sexual partners about STI testing and sexual health is healthy for relationships, and helps to create mutual responsibility.
Get Tested: Regular testing ensures early detection and treatment. If you’re sexually active with multiple partners, get tested every three months.
We know how much fun it is to sleep around, but if you're going to be promiscuous, just make sure you're safe about it.
Addressing Stigma
One barrier to preventing STI-related fertility issues is the stigma surrounding sexual health. Many people avoid testing out of fear or shame, which allows infections to go undetected and untreated. Normalizing conversations about STIs and emphasizing their commonality can encourage more people to take proactive steps. Remember, everyone has a body, and bodies sometimes need maintenance—no shame in that.
Can Fertility Be Restored?
If an STI has already impacted your fertility, all is not lost. PID and epididymitis can be treated with antibiotics when diagnosed at an early stage, and if in severe cases where an abscess has formed, surgery may be an option. There is unfortunately no way to reverse the scarring or damage to the reproductive tract affected by PID. Other options for conception like in-vitro fertilization (IVF) may be a pathway to get pregnant for those affected by infertility.
Final Thoughts
Not everyone is interested in having children, and as such, fertility may not be a concern for you. Regardless, this is an important area of personal health that you deserve to understand fully. Yes, STIs can affect fertility, but the key takeaway is that most complications are preventable with regular testing, early treatment, and safe sex practices. By staying informed and proactive, you can protect your reproductive health and reduce the risks posed by these common infections. And remember, taking care of your sexual health isn’t just about avoiding problems—it’s about ensuring a future where your options remain open, whether you’re planning a family or simply safeguarding your well-being.
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