Lack of Diagnosis and Treatment of Sexually Transmitted Diseases (STDs) can Cause Infertility in Men and Women

Nova IVF Fertility is helping patients fight infertility with advanced Assisted Reproductive Technology (ART) in Coimbatore

Infertility is a condition where a couple is unable to conceive naturally, despite having unprotected sex for more than a year. Many factors can affect conception, including the presence of sperm and egg at the right time in a receptive environment. There are several tests that can help evaluate these different aspects of fertility health. While factors such as advancing maternal age, endometriosis, ovulation disorders, sperm malfunction and other lifestyle habits are culprits for infertility, there is a hidden trouble that most have not heard of – Sexually Transmitted Diseases (or) STDs. STDs can also lead to infertility in men and women.

What is an STD?

STDs are infections transmitted through unprotected sex which may include vaginal, anal or oral intercourse. These infections also spread through sharing IV needles, breastfeeding, or giving birth. Most STDs affect both men and women, but in many cases the health problems they cause can be more severe for women. If not properly treated, an STD could lead to potential infertility issues. There are many sexually transmitted diseases that one can come in contact with; of which Chlamydia and Gonorrhea are the most common ones and can have an adverse impact on one’s fertility health.

Discussing the implications of sexually transmitted diseases on fertility at a press meet held today, Dr. Meenakshi, Fertility Consultant, Nova IVF Fertility, Coimbatore said, “Sexually transmitted infections (STI) can cause pelvic inflammatory disease (PID) in women (an infection of the uterus and fallopian tubes) and epididymitis in men (inflammation of the coiled tube beside the testes). Complications from STIs can lead to infertility or an ectopic pregnancy (an embryo that grows outside the womb). In fact, if a woman with STI is pregnant, this can also infect her baby.”

Chlamydia and infertility

Chlamydia is a sexually transmitted disease which can easily be treated with antibiotics. The effects of chlamydia on fertility are well established and apply to both men and women. Chlamydia causes a large amount of inflammation (swelling) in the fallopian tubes which tend to get blocked, restricting the travel of fertilised egg to the uterus. This condition is also known as tubal infertility. Around one in five women with Chlamydia also develop PID. Often, these infections also affect the endometrial tissue, wherein the embryo fails to get implanted, thus leading to infertility.

The symptoms of chlamydia in men are pain while urinating, discharge from the penis and pain in the testicles. Around 50% of men with chlamydia will develop symptoms within one to three weeks of contracting the disease which makes it more noticeable for men than in women. However, men who suffer from Chlamydia may find that their sperm quality and motility has significantly decreased, leading to difficulty in conceiving.

Gonorrhea and infertility

Gonorrhea is an infection caused by a sexually transmitted bacterium that can infect both males and females. Gonorrhea most often affects the urethra, rectum or throat. In females, gonorrhea can also infect the cervix. As Gonorrhea can go undetected for long periods of time, tubal damage from the disease is common. About 10% - 20 % of women with Gonorrhea have symptoms of pelvic inflammatory disease. Gonorrhea has also been shown to cause problems with sperm health in many men.

Symptoms of gonorrhoea in men include painful urination, pain or swelling in one testicle and pus-like discharge from the penis, while for women, the symptoms include increased vaginal discharge, bleeding and painful intercourse.

Elaborating on the two main pelvic infections that can lead to infertility, Dr. Meenakshi further added, “Chlamydia and Gonorrhea are the two most common and preventable infections which cause PID. If left untreated, about 10-15% of women with these infection can develop PID. Chlamydia can also cause fallopian tube infection without any symptoms. PID and “silent” infection in the upper genital tract may cause permanent damage to the fallopian tubes, uterus, and surrounding tissues which can ultimately lead to infertility.”

Diagnosis for patients with STD who are infertile:

ALICE ( Analysis of Infectious Chronic Endometritis ) test
In case of women, the first step of treatment includes taking the vaginal or cervical swab for culture and finding the organism involved based on which antibiotics are prescribed to reduce the infection. An endometrial tissue is also given to the laboratory to undergo the culture during a routine diagnostic laparoscopy in order to detect the exact type of infection and the type of antibiotic that can be prescribed. In case of men, discharge as well as semen is sent for culture and sensitivity to detect the organism and antibiotics are prescribed.

The ALICE test is a microbial essay of the endometrial cavity which helps find the type of infection that is affecting the uterus and preventing the embryo from getting implanted. It also provides details on upgraded series of anti-biotics which are sensitive to the organisms. ALICE is a molecular microbiology tool used to diagnose subclinical infection of the endometrium that has been associated with infertility, especially repeated implantation failure and recurrent pregnancy loss. ALICE indicates the possible presence of bacterial pathogens, which can cause chronic endometritis or other diseases.
STI in Male:
For men, generally, being diagnosed with STD implies a block; sperms are formed in the epididymis and travels to a passage called the spermatic chord. In case of any infection, the chord gets affected. Over the course of its healing period, it develops a scar, which eventually, after a year or two, leads to obstructive azoospermia. Those diagnosed with this condition are advised retrieval of sperms directly from the testis or epididymis, followed by IVF.

“Over time, we have been witnessing a rise in the cases of infertility caused due to STDs in Coimbatore. We meet several patients on a day-to-day basis who are unaware that they are suffering from obstructive azoospermia. Most of them are only prescribed antibiotics, but the right diagnosis continues to remain the need of the hour. By assessing the microbiological environment that the embryo will encounter at implantation, test methods like ALICE can be beneficial for any patient wishing to conceive”, stated Dr Meenakshi.

The earlier the STDs are diagnosed and treated, the less likely it will cause problems with fertility. Having an STD test before trying for a baby also helps reduce the risk of passing an infection to your partner or child. It is always advisable to have protected sex to avoid contact with any STDs. While the infections can be treated with antibiotics, the treatment cannot reverse scarring of the reproductive organs once it’s already occurred—and it’s the scarring that can cause infertility.

Nova IVF Fertility (NIF) is among the largest service providers in the fertility space and has successfully achieved over 25,000 clinical pregnancies through IVF.

About Nova IVF Fertility

Nova IVF Fertility (NIF) is the among the largest service providers in the fertility space. NIF aims to bring advanced Assisted Reproductive Technology (ART) to India in partnership with IVF of Spain. The partnership has resulted in a substantial addition to Nova's IVF services and technology, including proprietary software, training, and quality management. With IVF's know-how and vast international expertise, NIF brings the same exceptional standard of processes, protocols, and policies to India.

In addition to providing core procedures such as IUI, IVF, and Andrology services, NIF offers several state-of-the-art technologies such as Vitrification for preserving embryos and eggs, ERA to find out the timing of the uterus' capacity to accept embryos, PGS and PGD for the transfer of genetically normal embryos – all procedures that significantly improve the chances of a pregnancy following IVF-ICSI, even in patients with multiple previous failures. NIF currently operates 20 fertility centres in India (Ahmedabad (2), Bengaluru (3), Chennai, Coimbatore, Hisar, Hyderabad, Indore, Jalandhar, Kolkata, Lucknow, Mumbai (2), New Delhi (2), Pune, Surat, and Vijayawada).

For further information, visit www.novaivifertility.com