Certain untreated Sexually Transmitted Diseases, or STDs, can decrease fertility in both males and females. STDs spread through sexual contact with an infected partner through oral, anal, or vaginal sex. STDs are most prevalent in adolescents and young adults ages 15 to 24.
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Chlamydia and gonorrhea are the most common bacterial STDs. Doctors often describe them as “silent” infections because the majority of people diagnosed with chlamydia or gonorrhea do not have any symptoms. For this reason, the Centers for Disease Control and Prevention recommend annual chlamydia and gonorrhea screening for all sexually active males and females age 25 and younger. Untreated chlamydia and gonorrhea can adversely affect the fertility of both men and women.
In women, gonorrhea and chlamydia can cause cervicitis, inflammation of the cervix, or urethritis, inflammation of the urethra. The urethra drains liquid from the bladder. If symptoms are present, they may include abnormal vaginal discharge, vaginal spotting and dysuria, a burning sensation during urination. Left untreated, 10 to15 percent of chlamydia infections will cause an upper genital tract infection in the uterus or the fallopian tubes.
An infection in the upper genital tract is called Pelvic Inflammatory Disease or PID. PID can be either asymptomatic or symptomatic. When symptoms do occur, they can include pelvic pain, abnormal vaginal discharge, vaginal bleeding, nausea and fever. PID is a particularly serious condition because it can permanently damage the uterus and the fallopian tubes.
When eggs are released from the ovaries, they travel through the fallopian tubes before being fertilized by sperm and implanted in the uterus. Fallopian tube scarring caused by STDs can prevent the egg and sperm from ever meeting, thereby inhibiting fertilization. The scarring also increases the risk for an ectopic pregnancy, a pregnancy inside the fallopian tubes. An ectopic pregnancy can result if the scarring in the fallopian tube prevents a fertilized egg from entering the uterus. An ectopic pregnancy is potentially life-threatening because it can rupture the fallopian tube. Without emergency surgery, a woman will quickly die from internal bleeding.
Gonorrhea and chlamydia also cause urethritis in men, the majority of whom also do not display any symptoms. When symptoms occur, they can include dysuria, pain or redness around the opening of the penis, or spontaneous penile discharge. Left untreated, the infection can spread up the genital tract and cause epididymitis, which is inflammation of the epididymis. The epididymis is a structure that connects to the testes through ducts. Sperm made in the testes travels to the epididymis where they mature.
Acute epididymitis causes redness, warmth, and swelling of the scrotum and testes, usually on one side. Recurrent or untreated infections can cause chronic epididymitis, which can lead to infertility by damaging sperm mobility, function and sperm count.