Sexually Transmitted Infection - Fertility

This video, titled "Sexually Transmitted Infection - Fertility" by Gynae Consultant, details how Chlamydia trachomatis affects reproductive health, its asymptomatic nature, and clinical guidelines for testing and management during fertility treatments.

Impact on Fertility

• The Nature of the Infection: Chlamydia is the most common sexually transmitted infection (STI) in Europe, with rising incidence rates, particularly among younger women. While it is easily treatable with antibiotics, its primary danger is that it is often entirely asymptomatic and goes unnoticed.
• Female Fertility: If left untreated, the infection can cause pelvic inflammatory disease and directly damage or block the fallopian tubes, leading to sub-fertility.
• Male Fertility: Evidence suggests chlamydia can also negatively affect sperm in men. Notably, while antibiotics clear the active infection, they do not reverse existing damage or automatically improve sperm quantity and quality once affected.

Testing Methods

The video highlights two distinct diagnostic approaches based on the stage of the infection:

• Swab Tests (Current Infection): To detect an active, current infection, a swab must collect cells from the vagina or cervix to test for chlamydia DNA.
• Serological Blood Tests (Previous Exposure): A blood test looking for chlamydia antibodies can determine if a patient has had a past infection. If the antibody test returns positive, further investigation—such as a laparoscopy—may be offered to check for tubal damage.

Prevention and Fertility Treatment Protocols

Because of its hidden nature and long-term implications, the clinician emphasizes strict protocols to prevent re-infection and protect patients during clinical procedures:

• Partner Screening: Anyone suspected of exposure should be screened. If an infection is confirmed, all sexual partners must be tested and treated simultaneously to prevent passing the infection back and forth.
• Invasive Fertility Diagnostics: Prior to any diagnostic procedure that evaluates the fallopian tubes using dye—such as a Hysterosalpingography (HSG) or Hysterosalpingo-Contrast-Sonography (HyCoSy)—patients must be screened for chlamydia and given prophylactic antibiotic cover.
• Assisted Reproduction Protocols: Routine screening and antibiotic coverage are required during invasive fertility interventions like egg collection. Similarly, couples preparing for cryopreservation (egg, sperm, or embryo freezing) must receive thorough counseling and screening before moving forward.