Do STI's Affect Fertility?

by Julia Barr

When you think about practicing safe sex, you likely think about avoiding unplanned pregnancies and preventing STI transmission. Your sexual health education also likely emphasised preventing pregnancy and STIs. Since we spend much of our sexually active years avoiding pregnancy, it might not have registered, to the same extent, that STIs can, in fact, lead to infertility.

This lack of general knowledge regarding STIs and infertility was the finding of a 2013 study, which interviewed college and university students ages 16-26 across Southeast England: ‘whilst young people do have a basic awareness of issues related to STIs and infertility, they still lack a clear and consistent understanding’.

The study concluded that ‘sexual health education needs to begin at an earlier age and needs to focus on describing the process of how an untreated STI may result in infertility alongside emphasising the consequences, in an age-appropriate way. Education is crucial in order to protect young people from developing potentially life-altering long-term problems with fertility’.

We at Yoxly have to agree: more widespread and comprehensive sexual health education is a must! When it comes to practicing safe sex, knowledge is power. Whether it is a better understanding of STI transmission, dispelling popular myths, or learning the potential consequences of an undiagnosed STI, education and an open conversion around sexual health is how we can make best practice our standard practice.

We can’t emphasise it enough: best practice = routine STI testing. Whether or not a family is in your future, if you want to maintain a healthy, worry-free sex life, regularly getting an STI test is your best way of avoiding any complications in the future.

Fact 1: Chlamydia is the most frequently diagnosed STI in England, with young people (aged 15–24 years) being the most at-risk population.

Fact 2: Chlamydia is also one of the two most common STIs contributing to female and male infertility (the other being gonorrhoea).

Chlamydia is a particularly tricky STI because it is often symptomless; yet if left untreated, women with chlamydia are at risk of developing pelvic inflammatory disease (PID), which can cause complications including chronic pelvic pain, increased risk of ectopic pregnancy and tubal factor infertility (TFI). Indeed, an estimated 10-16% of untreated chlamydia infections result in the development of clinical PID. There is also evidence that babies born to mothers with chlamydia may suffer from conjunctivitis and pneumonia, and that women who have previously had chlamydia may be at increased risk of adverse birth outcomes including preeclampsia, spontaneous preterm birth or stillbirth.

The good news? Treatment for chlamydia is relatively straight-forward and very effective. The two most commonly prescribed antibiotics are azithromycin and doxycycline—which, when prescribed by a medical professional and taken consistently and in full, are effective in curing chlamydia in 95% of cases.

While a symptomless STI presents its challenges, there’s a likely solution: regular chlamydia screening. As Public Health England outlines, by ‘diagnosing and treating asymptomatic chlamydia infections, chlamydia screening can reduce the duration of an infection, thereby reducing the chance of developing a fertility-related complication’.

For the last two decades, Public Health England has been trying to do just that. Established in 2003, the National Chlamydia Screening Programme (NCSP) recommended that all sexually active adults under the age of 25 be tested for chlamydia at least annually or upon the change of sexual partner(s) (whichever is more frequent). Among its objectives are to ensure all sexually active under-25 year olds are informed about chlamydia and to normalise the idea of regular chlamydia screening among young adults so they expect to be screened annually or when they change partners. The NCSP promotes opportunistic screening, ‘offering young adults a test when they attend services such as GPs, community sexual and reproductive health services, pharmacies, and specialist genitourinary medicine services’. In this way, more asymptomatic cases of chlamydia can be detected and treated earlier on, reducing the risk of further complications—infertility and otherwise.

Public Health England data shows that of the 1.34 million chlamydia tests carried out in England among 15 to 24 year olds, 134,000 (10%) resulted in a positive diagnosis. That’s 134,000 individuals who, with one positive test, could seek appropriate treatment, reducing their risk of more serious complications in the future. 

The moral of the story? Don’t get lazy with your STI testing! Even if a family isn’t in your immediate future, you might want to know it’s a potential for your long-term future.

As always, Yoxly is here to help make STI testing as easy, discrete and regular as possible. Click here for more information on our test kits and our recommendations for frequency of testing.

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Julia Barr is a recent graduate of the University of Cambridge where she studied postcolonial British history. She currently serves as grant writer with Kar Geno, a Kenyan-based non-profit that assists HIV/AIDS-affected women and provides sexual health education to school-aged children.

 

Yoxly's Awesome Contributors (YACs) are a diverse group of individuals who are passionate about public health, and committed to furthering our mission. Yoxly provides a platform where a variety of sexual health topics (some more awkward than others!) can be explored, in an informative and non-judgmental way. If you'd like to become one of Yoxly's Awesome Contributors, contact us!

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