Sexually transmitted infections (STIs) are common, with over 1 million STIs acquired every day worldwide and where the majority are asymptomatic. In South Africa, the prevalence of STIs is also high. Fortunately, most do not pose any threats as long as they are diagnosed, and treated early enough. However, there are some instances where negative consequences can arise, such as infertility. Infertility can be defined as a couple or individual who cannot get pregnant despite having regular unprotected sex. It usually occurs when STIs are left untreated for an extended period of time, generally because an individual may be asymptomatic. Below we discuss which STIs cause infertility and pregnancy complications, how it transpires and the treatment and preventative measures.

STIs and Infertility

Which STIs cause infertility?

The two most common STIs that cause infertility include chlamydia and gonorrhoea. However, others that are just as prevalent can also cause infertility and pregnancy complications in both men and women. These are discussed in more detail below.

Chlamydia & Gonorrhoea

In South Africa, in 2017, it was estimated that in both women and men aged between 15 to 49 there were 5.8 million new cases of chlamydia and 4.5 million new cases of gonorrhoea. Along with this high prevalence, many cases of chlamydia and gonorrhoea are asymptomatic and are therefore left untreated. As a result, these STIs can cause pelvic inflammatory disease (PID) in women and epididymitis in men, which ultimately cause preventable infertility.

In women, untreated chlamydia and gonorrhoea can spread to the womb, ovaries or fallopian tubes, causing PID. PID causes swelling and inflammation in the fallopian tubes, and as it progresses, scar tissue can form both on the inside and outside of these tubes. As the fallopian tubes transport the eggs to the uterus, this scar tissue blocks the tubes making a fertilised egg unable to reach the uterus and consequently, a woman cannot fall pregnant.

In men, untreated chlamydia and gonorrhoea can cause epididymitis. Epididymitis is an inflammation of the tube that stores and transports sperm from the testicle. Therefore, this inflammation blocks the tube, preventing sperm from reaching an egg during intercourse and thus rendering a man infertile.

Other STIs which cause infertility and pregnancy complications

• HIV: Having HIV can sometimes make it more difficult to conceive, and it is possible to pass HIV to your baby. Although there are responsible ways to conceive a child with HIV, it is advised that you consult with your doctor on the best approach as they will be able to guide you every step of the way.
• Herpes: If a woman has herpes, there is a risk she may pass it on to the baby. However, taking precautions such as taking medication to suppress the virus and having a cesarean section can limit this. Additionally, some research suggests that herpes may reduce the sperm count in males, although the research on this is limited.
• Mycoplasma Genitalium: Infections with mycoplasma genitalium have been associated with PID and infertility in females and males.
• Syphilis: During pregnancy, if a woman has syphilis, she can pass it on to her baby before they are born. Additionally, there is a higher possibility of miscarriage, stillbirth and premature birth.
• Trichomonas: Complications are rare however if a woman has trichomonas during pregnancy, the baby may be born prematurely or with a low birth weight.

How is it treated and prevented?

Infertility due to STIs, such as chlamydia or gonorrhoea, can be easily treated with antibiotics, as this treats the underlying infection. Infertility or pregnancy complications due to syphilis, trichomonas and mycoplasma are also easily treatable with a course of antibiotics. However, genital herpes and HIV requires antiviral medication and treatment along with management of the virus and guidance and advice from your doctor.

The best way to avoid such issues arising is to avoid getting STIs. Always wear a condom and regularly get tested for STIs. If you think you have been in contact with someone with an STI or a suspected STI, it is recommended that you get tested and treated as soon as possible, as the symptoms may not always show up.

Our Partner Doctors are currently unable to treat HIV/Aids via our platform, however we are working hard to add a HIV/Aids testing and treatment service offering as soon as possible.

We do not offer any pregnancy or fertility treatment as part of our services.