A 'Silent' Cause Of Infertility That Should Be On Your Radar


When it comes to fertility often several factors come into play, including one’s age, lifestyle, and underlying health status. Since not all factors are easily identifiable, some couples struggle for months or years despite putting forth their best efforts to conceive a child. One of the more discreet factors that can contribute to infertility is the presence of a hidden sexually transmitted disease or infection.

In the general public sexually transmitted diseases are rarely discussed as being a potential threat to one’s fertility, yet they remain as a leading cause of infertility in both men and women. Since some sexually transmitted infections present asymptomatically it is possible for them to go undetected and be easily passed onto others without suspicion.

The rates of chlamydia and gonorrhea alone have risen dramatically in Canada over the last decade and continue to do so. Chlamydia and gonorrhea are the top two ‘silent’ sexually transmitted infections, meaning that the majority of people who acquire them don’t present with any symptoms so many don’t even realize that they have them. When symptoms are present, many patients will report burning with urination, abnormal discharge, pelvic pain, and spotting between periods. While they are treatable, they are quickly becoming resistant to the standard antibiotic treatments that are available. These infections typically co-occur together and, when left untreated, can cause a host of complications that may impair fertility. One such complication is called pelvic inflammatory disease.

Pelvic inflammatory disease develops when an infection spreads to the upper reproductive system where the uterus, fallopian tubes, and ovaries are located. While it often progresses silently without symptoms, the structural damage that can result within the reproductive organs can be permanent and quite devastating. Chlamydia and gonorrhea are responsible for the majority of cases, however not all organisms that cause it are sexually transmitted. When symptoms do occur, patients may complain of chronic pelvic pain, pain during intercourse, vaginal discharge, abnormal uterine bleeding, painful urination, nausea, and fever.

Untreated cases of pelvic inflammatory disease are often characterized by the formation of adhesions and scar tissue within the organs of the reproductive system, which can cause problems down the road when the patient is looking to conceive. When scar tissue develops within the fallopian tubes they can become significantly inflamed with fluid and even blocked, which increases the risk of having an ectopic pregnancy – a pregnancy in which the embryo implants outside of the uterus. Scar tissue in other locations can also interfere with the process of ovulation, fertilization, implantation, and may increase the risk of complications during pregnancy, including miscarriage, premature birth, and stillbirth.

Even if you haven’t been with a new partner in several years it is worth screening for STIs and STDs if you are trying to or planning to conceive. Screening is inexpensive and the earlier that it is caught, the less likely it will impact your fertility. If you are not quite ready to conceive but wish to in the future, practicing safe sex and using contraception is advised to preserve your future fertility.

Yours in health,

Dr. Jessica Geil, ND

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