Reproductive Health Awareness Month

Reproductive health is a broad subject, covering everything from family planning and contraception, to fertility and reproduction – or having children, to safe and healthy pregnancy and childbirth, and even to fertility preservation for those whose future fertility is at risk due to, for example, cancer treatments.

Reproductive Health Awareness Month is a great opportunity to learn more about the amazing and complex human reproductive system, and also to understand why safe sex is so vital to good reproductive health, now and in the future.

Why is safe sex so important to fertility?

Reproductive health, or fertility – the ability to have your own biological child – is an asset that is far more valuable than people realise, but only until they want their own baby and can’t do it naturally. Finding out that you will not be able to have a child without medical assistance can be devastating.

“Involuntary childlessness, in which a person wants to but cannot become a parent, is an increasingly prevalent problem worldwide,” explains Dr Nicholas Clark, a qualified Gynaecologist and Obstetrician, and a director of Medfem Fertility Clinic in Sandton, Johannesburg, South Africa, in a video you can watch here. “Infertility remains the leading cause of this and a significant contributing factor is sexually transmitted infections, or STIs for short.”

There are a number of ways in which STIs affect fertility, as discussed below. But, fortunately, preventing STI’s is as simple as always practicing safe sex.

What are STIs?

The World Health Organisation says that there are more than 30 different bacteria, viruses and parasites that are known to be transmitted through sexual contact, including vaginal, anal and oral sex.
Eight pathogens are linked to the greatest incidence of STIs. Of these, four are currently curable:
* syphilis,
* gonorrhoea,
* chlamydia, and
* trichomoniasis.
The other four are incurable viral infections:
* hepatitis B,
* herpes simplex virus (HSV),
* HIV, and
* human papillomavirus (HPV).

How do STIs affect fertility?

The World Health Organisation notes that STIs can have serious consequences beyond the immediate impact of the infection itself, and have a direct impact on sexual and reproductive health through stigmatisation, infertility, cancers, pregnancy complications and an increased risk of HIV. In addition, some STIs can also be transmitted from mother-to-child during pregnancy, childbirth and breastfeeding.

Hepatitis B resulted in an estimated 820 000 deaths in 2019. STIs like herpes, gonorrhoea and syphilis can increase the risk of HIV acquisition. Cancers such as cervical cancer are caused by HPV infection, and these cancers and the treatment thereof can result in infertility. In addition, STIs such as gonorrhoea and chlamydia are major causes of pelvic inflammatory disease and infertility in women. Mother-to-child transmission of STIs can result in stillbirth, neonatal death, low-birth weight and prematurity, sepsis, neonatal conjunctivitis and congenital deformities.

Dr Clark explains further: “Chlamydia and gonorrhea infections are by far the most commonly reported STIs, with chlamydia often being an asymptomatic or silent infection. Mycoplasma and trichomonas are other commonly reported infections which may have a negative impact on fertility and the vaginal microbiome, and disturbances of this microbiome may contribute to and play a role in some cases of infertility. Three fertility effects are at play when it comes to STIs. Both the rate of miscarriage – defined as pregnancy loss up to 20 weeks of gestation – as well as the rate of later intrauterine death – are increased. In addition, the early neonatal death rate is increased.

“Given all these effects on fertility and pregnancy, it is important for couples to understand the risks of an STIs infection and to take all necessary precautions to prevent an STI from developing.”

How to prevent STIs and the infertility it can cause

Fortunately, preventing STIs – and the infertility it can cause – simply requires practicing safe sex!

“Anyone who is sexually active should be familiar with the basics about how to stay safe. So let’s talk about safe sex, and how it can protect your fertility,” says Dr Tony Rodrigues – a reproductive medicine specialist and a founder and director of Medfem Fertility Clinic in a video you can watch here. “There’s no need to be shy when it comes to talking about safe sex: it’s an important conversation to have, and it’s one that can help keep you and your partner safe and healthy. Safe sex means protecting yourself and your partner from sexually transmitted infections and unplanned pregnancies.”

He adds that safe sex practices such as using condoms or other barrier methods during sexual activity can reduce the risk of sexually transmitted infection and unintended pregnancy – and these methods do not impact future fertility. However, NOT using safe sex practices can definitely have a negative impact, because fertility can be affected by sexual health.

“There are a lot of different ways to have safe sex, and it’s important to find the right one for you and your partner,” says Dr Rodrigues. “No matter what type of safe sex you choose, be sure to talk to your partner about it. Make sure you both understand how to use the method you have chosen, and be sure to have plenty of supplies on hand. It’s also recommended that you discuss any concerns with a qualified healthcare provider. Safe sex is important, and it’s worth taking the time to make sure you’re doing it right.”

Dr Clark adds that poor communication within relationships, ignorance, and often just the taboo nature of the topic means that unchecked infections will occur more frequently, with an unnecessary toll on the ability to conceive and carry a healthy pregnancy. “Healthy interpersonal communication, education, early recognition of symptoms, screening, treatment of acute infections, contact tracing, and safe sexual practices will go some way to preventing the spread of STIs.”

Sadly, most people only realise the impact of STIs on fertility once it is too late.

Can infertility due to STIs be treated?

While prevention is definitely better than cure, there are treatments to treat the STI and potentially restore fertility if it has been negatively affected.

For example, where a woman’s fallopian tubes are blocked as a result of an STI infection, there are procedures to bypass blocked fallopian tubes, such as in vitro fertilisation. Where an STI caused male genital tract obstructions, sperm extraction and intracytoplasmic sperm injection (ICSI) could form part the fertility management.

Many instances of infertility caused by STIs can be treated and a consultation with a registered and qualified fertility specialist is a crucial first step that should not be delayed.

Are you concerned about your reproductive health?

To maintain good reproductive health, and optimise future fertility, it’s important to practice safe sex and to be proactive about it, because the consequences of not using protection are severe.

Reproductive health and fertility can be also be impacted by a variety of other factors including age, genetics, lifestyle, medical conditions and overall physical and sexual health.

If you are concerned about your reproductive health, whether due to STIs or other issues, we invite you to reach out to one of our fertility specialists at Medfem Fertility Clinic, by simply clicking here to book an initial consultation or contacting us telephonically on +27 (11) 463 2244.

Our Fertility Specialists can also meet with You During a Virtual Consultation Via Zoom or Skype. Click here to book a virtual consultation now.

We look forward to meeting you at Medfem Fertility Clinic!