Everyone has probably wondered "can I actually have children?" at some point in their lives. This is a question that can begin to gnaw at you, become a source of insecurity and even affect your self-image. Consequently, many people want to do everything they can to protect their fertility and increase their chances of a successful pregnancy. Did you know that this can also be done by getting tested and treated for STDs?

The road to pregnancy

In the normal situation, each month an egg matures in one of a woman's ovaries, after which it is released into her abdominal cavity during ovulation. There he has to find his own way over a small distance to the opening of a fallopian tube. Once there, the egg is then slowly moved by tiny vibrating hairs towards the uterus. If sperm cells are also present, the egg cell can be fertilized. Fertilisation can take place anywhere in the aforementioned process, but the fertilised egg can only develop into a baby if it can implant itself in the womb. It is therefore extremely important for your fertility that the fallopian tubes, uterus, cervix and vagina are healthy and well accessible to sperm cells and (fertilised) eggs!

ls this not the case, then as a woman you are more likely to:

• infertility
• reduced fertility
• ectopic pregnancies
• miscarriages
• premature births
• congenital anomalies

STDs in women can cause all of these things and thus reduce the chances of pregnancy or increase the risks during pregnancy!

In men, inflammation of the vas deferens or epididymis, for example, can also lead to infertility due to scarring and constriction. Infectious diseases, such as STDs, account for 15% of cases of male infertility.

So STDs in men can also reduce the chances of pregnancy!

STDs and getting pregnant

Chlamydia

Deze bacterie geeft in 90% van de vrouwen en 50% van de mannen helemaal geen klachten. Als een vrouw er te lang mee rondloopt kan de bacterie opstijgen naar de onderbuik en een ontsteking van het kleine bekken geven: pelvic inflammatory disease (PID). Wel 50% van de gevallen van PID komt door chlamydia! Door flinke ontsteking van de eileiders gaan die dichtzitten en kunnen de (bevruchte) eicellen de baarmoeder niet meer bereiken, met dus meer kans op onvruchtbaarheid of buitenbaarmoederlijke zwangerschappen.

Even women with fertility problems where the fallopian tubes were still open after a chlamydia infection were still 33% less likely to become pregnant. This is thought to be partly because the immune response to the bacteria interferes with implantation and fetal development.

In addition, chlamydia causes adhesions in the abdominal cavity, which makes operations (such as caesarean sections) more risky.

A poorer seed quality is measured in men with a chlamydia infection.

Fortunately, not every woman develops fertility problems after a chlamydia infection! According to STI AIDS Netherlands, it occurs in less than 1% of women with chlamydia, an estimated 500 women in the Netherlands each year.

Gonorrhea

Net als chlamydia veroorzaakt gonorroe als het opstijgt PID, ongeveer 20% van de gevallen wordt erdoor veroorzaakt. Ook hebben veel mensen er geen klachten van: tot 60% van de vrouwen en 10% van de mannen. Gonorroe vergroot daarnaast de kans op vroeggeboorte, een te laag geboortegewicht en aangeboren afwijkingen zoals blindheid en gewrichtsontstekingen.

Mycoplasma

This is a sexually transmitted bacterium that can live in your cells and often causes an inflammation of the urethra in men. In infertile women it is found up to 4 times more often than in fertile women that they have ever had mycoplasma. It also gives a 5 to 6 times higher chance of ectopic pregnancies.

Op zichzelf veroorzaakt mycoplasma minder schade dan chlamydia en gonorroe, maar gecombineerd doet het juist extra schade. Ook is aangetoond dat mycoplasma zich kan binden aan zaadcellen en zo een lift kan krijgen naar de baarmoeder of buikholte.

Trichomonas

The relationship between the parasite trichomonas and fertility has been relatively little investigated. What has already been found in certain studies is that women who indicated that they had once had trichomonas were twice as often infertile due to constricted fallopian tubes. The chance of infertility seems to increase if you have trichomonas infection more often.

In a combined infection with chlamydia, PID is seen much more often. Possibly this is because chlamydia gets a lift because of the trichomonas parasites.

Furthermore, the parasite probably works against sperm cells by eating them or disrupting their movement.

Herpes

Especially if you as a woman contract this virus for the first time during pregnancy, it is dangerous for the unborn child because it can lead to miscarriages, stillbirth and birth defects. If you have had herpes before, and that can be genital herpes or cold sores, you already have antibodies and the risk to your baby is much lower.

Yet even a pregnant woman who has been carrying the herpes virus for years can infect her child around birth. In newborns, it can then cause serious consequences such as sepsis (blood poisoning), seizures and liver failure. Pregnants with herpes blisters at the time of delivery are therefore advised to undergo a cesarean section.

Better safe than sorry!

Fortunately, most STDs are treatable and by no means always lead to problems with your fertility or pregnancy. Moreover, by using condoms and getting tested first, you can prevent an STD infection altogether.

Avoid grief for you and your (future) partner, get tested and treated for STDs on time. You can get tested at Onedayclinic at the following locations:

Amsterdam, Utrecht, The Hague, Rotterdam, Eindhoven and Nijmegen.

Sources

• D Pellati, et al. Genital tract infections and infertility. European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 140, Issue 1, 2008, Pages 3-11
  https://www.sciencedirect.com/science/article/abs/pii/S030121150800136X
• DG Tsevat, et al. "Sexually transmitted diseases and infertility." American journal of obstetrics and gynecology 216.1 (2017): 1-9.
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193130/
• Kelly A. Cunningham, Kenneth W. Beagley, Male Genital Tract Chlamydial Infection: Implications for Pathology and Infertility, Biology of Reproduction, Volume 79, Issue 2, August 1, 2008, Pages 180-189
  https://academic.oup.com/biolreprod/article/79/2/180/2557492
• https://lci.rivm.nl/richtlijnen/chlamydia-trachomatis-en-lymfogranuloma-venereum
• Heumann, Christine L et al. "Adverse Birth Outcomes and Maternal Neisseria gonorrhoeae Infection: A Population-Based Cohort Study in Washington State." Sexually Transmitted Diseases 44.5 (2017): 266-271.
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407319/
• Fernandes ND, Badri T. Congenital herpes simplex. [Updated 2019 Dec 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from:
  https://www.ncbi.nlm.nih.gov/books/NBK507897/
• Straface, Gianluca et al. "Herpes simplex virus infection in pregnancy." Infectious diseases in obstetrics and gynecology 2012 (2012): 385697.
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3332182/