Past Sexually Transmitted Diseases (STDs). . . Fertility Today
Chlamydia, a sexually-transmitted bacterial infection, is the most common STD in the U.S., with about three million new cases occurring each year. While it’s usually easily treatable with antibiotics, only about 30 percent of women actually know they have it. There may be no symptoms at all, or the kinds of symptoms–like fever and aches–that can easily be chalked up to something else, such as the flu. Often, symptoms resolve themselves but the infection remains.
“Chlamydia may not be diagnosed until a woman is trying to get pregnant,” says Dr. Damewood. “If it’s silent, it’s possible for a woman to have low-grade or moderate damage to her fallopian tubes, which can cause infertility.” A recent Swedish study also showed that chlamydia in men (which rarely causes any symptoms) has a negative effect on sperm.
Gonorrhea, the other major STD, affects about 700,000 people per year and usually causes no symptoms in women. Like chlamydia (which often accompanies gonorrhea), it can result in tubal damage.
An additional and serious risk inherent in either of these diseases is the possibility of Pelvic Inflammatory Disease (PID), a secondary infection of the uterus, fallopian tubes and/or cervix; 90 percent of PID infections are initially caused by chlamydia or gonorrhea, and 20 percent of women with PID experience infertility due to scarring of the fallopian tubes. PID is sometimes silent, but often causes lower abdominal pain, fever and vaginal discharge.
{loadposition frboost} Fortunately, chlamydia and gonorrhea can be prevented with condom use, and chlamydia is usually screened for during routine gynecological exams. That way, the disease can be detected and treated early, before there is damage to the fallopian tubes. If either STD has caused tubal damage, the tubes can often be repaired with microsurgery. When damage is significant, IVF may be needed to achieve pregnancy.
Past Surgeries . . . Fertility Today
When Lisa McClintick of St. Cloud, Minnesota, started trying to get pregnant at age 27, she was assured by numerous doctors that neither her Crohn’s disease (a chronic inflammatory disease of the gastrointestinal tract) nor the surgery she’d had for it would present a problem. But after two years of trying to conceive with no success and being told to “be patient,” she underwent testing, which revealed a misaligned ovary due to scar tissue that built up after the surgery; the misalignment made it harder for the egg to reach the fallopian tubes. In vitro fertilization might have worked, but she and her husband instead decided to adopt a child. They are currently in the process of adopting a second child.
The formation of scar tissue or adhesions (where scar tissue adheres to or joins together other organs) is not uncommon after abdominal or pelvic surgery, but it doesn’t always cause fertility problems. When it does, the problem can often be remedied by surgery to remove the tissue; IVF can bypass tubal problems completely. Other procedures capable of causing fertility problems are cone biopsies–used to diagnose cervical cancer–and dilation and curettage (D&C), which is done to remove excess tissue from the uterus after a miscarriage or abortion.
“People find it hard to accept that they have no control over fertility difficulties,” says Rovner-Ferguson. “When a crisis like infertility hits, there’s a natural tendency to look for a guilty party, something to point a finger at.” The important thing to know is that despite the decisions women made and the things they may have done before they were ready to become mothers, few of those past activities will come back to haunt them in their quest for parenthood.
A version of this article originally appeared in the Spring 2005 issue of Conceive Magazine.
Related Topics: Boost Fertility; Fertility Health
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