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Can STIs impact your chances of getting pregnant?

Can STIs impact your chances of getting pregnant?

Unfortunately, there is not a lot of open discussion around the topic of sexually transmitted infections. As a result, it can be quite challenging to get correct, unbiased information on STIs and their impact on reproductive health and fertility. There is still a stigma attached to the subject that leads to an atmosphere rife with misinformation and misinterpretation.

However, the matter is that STIs are more common than one might think, and there is nothing shameful about contracting one. The figures from health.gov.au reveal that 50% of sexually active people contract an STI before 25.

STIs happen, and there is no reason for feeling ashamed or embarrassed about having them. Fortunately, there are ways to treat and manage them with very effective medicine.

Many women in the TTC community are wary of STIs and the impact that they might potentially have on their ability to conceive. Whether you are actively trying to conceive or are pregnant, STIs can impact your body differently. This post will break down the facts about some of the most common STIs and how they can affect your reproductive health and fertility.

The most common STIs in Australia is chlamydia and can cause issues with fertility. 

Why do we say STIs instead of STDs?

Over that last decade or so, the terminology describing sexually transmitted ailments has evolved a lot. Medical conditions such as Herpes, Gonorrhea, and Syphilis were called Sexually Transmitted Diseases (STD) in the past. However, they have been referred to as Sexually Transmitted Infections (STIs) over the last few years. There is an excellent reason for changing the terminology here.

A disease refers to a medical condition having obvious symptoms or signs. However, most of the so-called STDs have such mild symptoms that can be easily overlooked or no symptoms at all. Hence calling them a ‘Disease’ is not correct. Therefore, the term ‘Infections’ denotes the medical conditions where the symptoms might be non-existent.

As some STIs can remain asymptomatic for quite a long time, it might be possible to have an STI and not even know about it at all. Although most STIs can be quite easily managed using medicines, it can be challenging to see if you have them in the first place.

The best thing is to equip yourself with as much knowledge about STIs as possible in such a scenario. Knowing these conditions can help you spot the early signs and prepare a plan of action to combat them.

Can you get pregnant with STIs?

Absolutely! It is possible to get pregnant with most STIs. That said, if you are TTC, your doctor might recommend a preconception STI screening. This testing can reveal STIs such as Gonorrhea and Chlamydia even if they are asymptomatic so that they can be cured with appropriate medication before you become pregnant.

The best way to avoid any complications down the line is to get the STI testing done early on in the pregnancy. You can get pregnant even if you have an incurable viral STI such as Herpes or HIV, but your doctor might have to take steps to mitigate risks.

Can STIs affect fertility?

An STI can become a problem if it is left untreated. Women with ovaries can develop Pelvic Inflammatory Disease (PID) due to untreated STIs. PID affects the uterus, Fallopian tubes, ovaries, and cervix, which might lead to infertility.

The Australian Journal of General Practice data suggests that around 17% of women with chlamydia develop PID if it is not treated. Hence, it is crucial to get tested for STIs often, especially if you are pregnant.

A chlamydia infection can quickly spread to the Fallopian tubes with only mild to moderate symptoms. It can remain undetected if you don’t get it tested and potentially cause permanent damage to your reproductive system.

Untreated gonorrhea can also spread to your uterus and Fallopian tubes causing PID and, potentially, infertility. However, you can still opt for fertility treatments, in that case, to get pregnant. For instance, if the Fallopian tubes are damaged to the extent that they are rendered non-functional, you can still get pregnant using techniques such as IVF.

 ABC STIs are increasingly common, but stigma around them and fertility
Incidence of sexually transmissible infections and blood-borne viruses in Australia. (Australian Institute of Health and Welfare)

Bacterial STIs that can affect pregnancy and birth

Let’s begin our discussion with bacterial STIs that are curable with a course of appropriate medication. We will cover the effects of these STIs before conceiving, during pregnancy, and childbirth.

Chlamydia

With four million cases of infection, chlamydia is one of the most common STIs in Australia. It is so common that it is tested during your very first prenatal doctor’s appointment.

In many cases, chlamydia can remain asymptomatic. However, the most common symptoms include vaginal bleeding, pain in the pelvic region, vaginal discharges, and painful urination when it is symptomatic. However, the good news is that chlamydia is completely curable with antibiotics.

Risks during pregnancy: According to the CDC, untreated chlamydia can be dangerous for the fetus, and it can cause preterm labour and even miscarriage. If the baby is exposed to the bacteria during delivery, it may develop eye or lung infections and, in rare cases, can be fatal.

How is chlamydia treated when you are pregnant? The first line of treatment is getting an entire course of antibiotics. The infant will receive antibiotics in the eyes to prevent any eye infection early on if the mother is still not cured.

Gonorrhea

Gonorrhea is a similar bacterial STI to chlamydia. Both gonorrhea and chlamydia are usually contracted together. Some of the most common symptoms in women include painful urination, increased vaginal discharge, bleeding between periods, and abdominal cramps. It is a treatable infection and is tested for during the preconception screening.

Risks during pregnancy: The Department of Health warns of gonorrhea being responsible for preterm delivery, premature rupture of the membranes covering the baby, and even miscarriage. The water surrounding the fetus (amniotic fluid) can also become infected in some cases leading to eye infections in the unborn baby.

‌How is gonorrhea treated when you are pregnant? As with chlamydia, the first-line treatment is an entire course of antibiotics. The newborn baby might receive antibiotics in the eye to prevent eye infections.

Syphilis

Syphilis infections are increasing in Australia and the world over. According to an estimate published in the Medical Journal of Australia (MJA), around 2 million pregnant women globally have syphilis.

Some of the most common symptoms of syphilis in women include sores, body rash that spreads all over the body, and a sore throat. Syphilis can spread to the brain, causing irreparable damage and can become fatal if left untreated. That said, once medical tests diagnose the condition, it can be cured with antibiotics.

Risks during pregnancy:  If syphilis is left untreated, it can have serious consequences, including preterm delivery, miscarriage, and stillbirth. The babies born to syphilitic mothers might have to face developmental delays and issues in vision and hearing.

‌How is gonorrhea treated when you are pregnant? The only antibiotic that is used to treat syphilis is penicillin. If you are allergic to penicillin, you would require special supervision during the treatment.

Does Herpes Impact Fertility?
What to Know About Herpes, Fertility & Pregnancy

Viral STIs that can affect pregnancy and birth

In stark contrast to bacterial STIs that can be cleared before pregnancy or during pregnancy, viral STIs are incurable. Once you contract a viral STI, it stays with you for your life. Let’s talk about some of the most common viral STIs and how they affect your pregnancy.

Herpes Simplex Virus

Herpes is one of the most common viral STIs caused by Herpes Simplex Virus (HSV). According to qld.gov.au, almost three-quarters of Australian adults are infected with HSV1. Furthermore, As many as 1 in 8 sexually active Australian adults have genital herpes. This prevalence of the condition means that the doctors have vast experience guiding women through pregnancies even if they have genital herpes. Some of the common symptoms include burning and itching in the genital area, which can cause the development of sores and blisters.

Two types or strains of HSV exist. HSV1 is a strain that predominantly causes cold sores or oral herpes, while HSV2 predominantly causes genital herpes. That said, both HSV1 and HSV2 can cause genital and oral herpes. It is important to get tested for herpes if you develop a cold sore.

Risks during pregnancy: Neonatal herpes is an infection of newborns and can have severe symptoms. Skin infections, brain infections, and vital organ infections are common in neonatal herpes.

How can herpes impact your prenatal care: The treatment plan for tackling herpes depends on when you contracted it, the severity of your outbreaks, and the time between your outbreaks. If you had had herpes before you conceived and are using antivirals to manage it, the chances of you transmitting it to your unborn baby are very low.

Suppose you had had genital herpes before you got pregnant. In that case, your OBGYN might start you on the prophylactic treatment of antibiotics around 36 weeks to prevent the formation of sores and lesions.

If you contracted herpes after you got pregnant, some extra precautions might be needed to prevent the transmission to the fetus.

If an active outbreak of herpes occurs during delivery, your doctor might suggest going for a C-section to limit the baby’s exposure to the virus. You might be put on antiviral medication even if you have had no outbreaks but are positive for the virus to decrease the likelihood of outbreaks as your due date approaches.

Human Papilloma virus (HPV)

Another common viral STI is HPV which affects up to 80% of people in Australia have HPV at some time in their lives. Several strains of HPV are responsible for the development of warts and causing precancerous changes to the cervical cells. Most of the HPV strains do not affect pregnancy or your chances of getting pregnant.

Pregnancy and birth risks: According to the CDC, there is minimal risk of HPV on pregnancy and the health of the unborn fetus. HPV is mainly confined to the vaginal and cervical regions. Although it can bring about precancerous changes in those tissues, which is a matter of concern, it does not affect the unborn baby.

In very rare circumstances, if a pregnant woman has genital warts during childbirth due to HPV, the baby might develop laryngeal papillomatosis that might need surgical intervention to cure. However, a C-section eliminates this risk.

How can HPV impact your prenatal care? One of the issues with HPV during pregnancy is that pregnancy hormones can increase the breakouts of genital warts. Warts can potentially block the birth canal, necessitating a C-section.

Human Immunodeficiency Virus (HIV)

HIV is a virus that can cause AIDS, and it spreads through unprotected sexual contact.

Pregnancy and birth risks: Newborn babies can contract HIV infection from their infected mothers during pregnancy, childbirth, or even during brat feeding. If this happens, the child will require antiviral medication for the rest of their lives to keep the viral load under control and undetectable. If a woman is diagnosed with HIV before getting pregnant, preventive medicines can lower the risk of transmitting the infection to the baby by about 2%.

How can HIV impact your prenatal care? An HIV diagnosis of the mother can be risky for the unborn child. Your doctor must be able to handle the high-risk situation. Some OBGYNs partner with other doctors specializing in treating HIV infection. You will need to take anti-HIV medications throughout your pregnancy. If the viral load is high, especially during the third trimester, your doctor might recommend a C-section to limit the baby’s exposure to the virus.

Hepatitis B

It is an infection that affects the liver transmitted through the blood and unprotected sexual contact.

Pregnancy and birth risks: Infants can be infected by a hepatitis-positive parent during pregnancy or childbirth. About 40% of the infants exposed to the maternal hepatitis virus develop active hepatitis, and about a quarter of them succumb to the infection.

How can hepatitis B impact prenatal care?: Getting proper treatment during pregnancy can considerably reduce the risk of passing on the infection to your baby. Your doctor will develop an appropriate care plan if you are hepatitis B positive during your pregnancy.

If you have contracted hepatitis B, you will receive antiviral medication to control the viral load and limit transmission. After the baby is born, it will receive a hepatitis B vaccine, significantly lowering the risk.

How can I prevent STIs during pregnancy?
How can I prevent STIs during pregnancy?

How can I prevent STIs during pregnancy?

One of the best and most effective ways to keep STIs at bay during pregnancy is to avoid sexual contact with new partners. Use barrier contraceptives such as dental dams and condoms during sex to limit exposure to STIs.

The bottom line of STIs

It is crucial to get screened for STIs during your preconception checkup. Catching an STI early on can help your doctor tailor a care plan that can protect you and your baby. If you have a high-risk infection such as HIV, look for an OBGYN specializing in handling such situations.

Many communities of women are going through their pregnancies and have delivered babies with STIs. Being a part of communities such as Project Accept can help you get the necessary support and hope while navigating through your pregnancy.

Most of all, remember one thing over 20 million STIs are being diagnosed every year, so you are not in this alone. It is possible to have a healthy and safe pregnancy even if you have STIs, as mentioned above, with proper care and precautions.