When you think about preparing for pregnancy, sexual health might not be the first thing that comes to mind.
But protecting your reproductive system from infections and damage is one of the most important steps you can take. Many Sexually Transmitted Infections (STIs) can silently impact fertility, sometimes long before you’re ready to conceive. In this article, we take a look at the link between sexual health and fertility.
Does sexual health affect fertility?
Absolutely. “Untreated STIs are a leading but preventable cause of infertility,” explains Dr Gorgy, Medical Director and Fertility Consultant at The Fertility & Gynaecology Academy. “Many infections are symptomless, meaning women and men may not know they are at risk until they try to conceive. Early infection testing and treatment are important to help protect your fertility.”
Some STIs, such as chlamydia and gonorrhoea, can cause inflammation in the testicles and other parts of the genital tract in men, and Pelvic Inflammatory Disease (PID) in women, leading to scarring in the fallopian tubes and making it difficult for eggs to travel to the uterus as normal. Others, like HPV, may not directly block conception, but can complicate or prolong it if a biopsy is required as it might make the environment in the cervical canal unfavourable for the sperm.
Let’s explore common STIs and how they can directly and indirectly affect fertility.
Impact of sexual health on fertility
- STIs: Even minor infections can damage reproductive organs if left untreated. Chlamydia and gonorrhoea are top causes of blocked fallopian tubes, while untreated syphilis can lead to miscarriage or stillbirth.
- Multiple sexual partners: Having multiple sexual partners increases your risk of contracting STIs, even if you’re using contraception. Regular screening helps catch infections early, before they can harm fertility.
- Safe sex practices: Using barrier methods like condoms helps to protect against STIs, and can also preserve long-term reproductive health by reducing the risk of PID-related infertility. However, barrier methods cannot provide guaranteed protection, particularly against human papillomavirus (HPV).
- Lifestyle choices: Smoking, alcohol consumption and poor general health can all lower your immune response, leaving you more vulnerable to infections that might damage fertility.
How common are STIs?
Recent data published by the UK Health Security Agency (UKHSA) reveals that diagnoses of some STIs – including gonorrhea, syphilis, chlamydia and HIV – have increased. While this could point to an increase in infection occurrence, it could also indicate wider awareness of STIs and testing, and an increase in availability of testing services.
Below is a table of the most common STIs in the UK and their prevalence.
Condition: Genital warts
Prevalence: Between 2010 and 2019, there was a 35% decline in genital warts diagnoses, however, it is still a common condition, with around 50,000 new cases treated each year in England
Notes: Genital warts is caused by certain strains of the human papillomavirus (HPV), which is a very common STI
Condition: Chlamydia
Prevalence: The detection rate per 100,000 population increased by 22.2%, from 1,733 in 2021 to 2,110 in 2022
Notes: Chlamydia is the most common STI in the UK, accounting for over half of all new STI diagnoses
Condition: Gonorrhoea
Prevalence: While gonorrhoea diagnoses dropped for all age groups from 2019 to 2020, there was a significant increase from 2021 to 2022, especially for those aged 15-24
Notes: The number of new gonorrhoea diagnoses reported in 2022 was the largest in any year since records began in 1918
Condition: Syphilis
Prevalence: From 2013 to 2019, syphilis diagnoses increased by 140%, briefly decreasing in 2021/22 before rising again in 2022 and 2023
Notes: In 2022, new syphilis cases were the highest reported since 1948
Condition: HIV
Prevalence: In 2023, 107,949 people in the UK received HIV care – an increase of 27% over the last 10 years
Notes: Overall, HIV testing has increased for gay, bisexual and other men who have sex with men, but testing has decreased for heterosexual men and women, and the majority of new cases in 2023 were within this demographic
| STI or STI-related condition | Prevalence | Notes |
|---|---|---|
| Genital warts | Between 2010 and 2019, there was a 35% decline in genital warts diagnoses, however, it is still a common condition, with around 50,000 new cases treated each year in England | Genital warts is caused by certain strains of the human papillomavirus (HPV), which is a very common STI |
| Chlamydia | The detection rate per 100,000 population increased by 22.2%, from 1,733 in 2021 to 2,110 in 2022 | Chlamydia is the most common STI in the UK, accounting for over half of all new STI diagnoses |
| Gonorrhoea | While gonorrhoea diagnoses dropped for all age groups from 2019 to 2020, there was a significant increase from 2021 to 2022, especially for those aged 15-24 | The number of new gonorrhoea diagnoses reported in 2022 was the largest in any year since records began in 1918 |
| Syphilis | From 2013 to 2019, syphilis diagnoses increased by 140%, briefly decreasing in 2021/22 before rising again in 2022 and 2023 | In 2022, new syphilis cases were the highest reported since 1948 |
| HIV | In 2023, 107,949 people in the UK received HIV care – an increase of 27% over the last 10 years | Overall, HIV testing has increased for gay, bisexual and other men who have sex with men, but testing has decreased for heterosexual men and women, and the majority of new cases in 2023 were within this demographic |
Understanding the prevalence of STIs is an important step in recognising their potential impact on fertility. Many infections can go unnoticed due to a lack of symptoms, which is why regular testing – especially for those planning to conceive – is essential. Early diagnosis and treatment not only protect your overall health, but can also safeguard your chances of having a baby in the future.
Specific STIs and their fertility-related risks
STIs can significantly impact both male and female fertility. In some cases, they may also pose a serious risk to unborn babies if passed on during pregnancy or childbirth. Below, we look at some of the most common STIs and the potential complications they can cause.
Chlamydia
Often symptomless, chlamydia is one of the leading causes of infertility in women. If left untreated, it can progress to PID, which may cause scarring and blockages in the fallopian tubes, making conception difficult or impossible. In men, chlamydia can affect sperm health and lead to infections in the testicles. Pregnant women with chlamydia risk passing the infection to their baby during labour/delivery, potentially causing eye infections or pneumonia in the newborn.
Gonorrhoea
Like chlamydia, gonorrhoea often presents without symptoms. When untreated, it can also lead to PID in women and infertility in both sexes due to inflammation and scarring of the reproductive organs. In pregnancy, gonorrhoea can cause complications such as miscarriage, premature birth or neonatal infections affecting the eyes and joints.
Syphilis
Syphilis can cause miscarriage, still birth or serious health issues for the baby if contracted during pregnancy. While syphilis is treatable, undiagnosed cases can lead to long-term damage in adults and be passed on to the baby as congenital syphilis, which may result in deformities or developmental issues.
HIV
While HIV itself doesn’t typically cause infertility, it may indirectly affect reproductive health through complications or co-infections. HIV can be passed to a baby during pregnancy, childbirth or breastfeeding if preventative steps aren’t taken. With proper treatment and medical care, the risk of mother-to-child transmission can be reduced to less than 1%.
Herpes (HSV)
Genital herpes does not usually cause infertility, but it can complicate pregnancy. If a person contracts herpes for the first time in late pregnancy, there’s a risk of passing it to the baby during delivery. Neonatal herpes can be life-threatening, so in some cases, a caesarean section may be recommended.
HPV and cervical cancer
HPV is extremely common and usually harmless, but certain strains are linked to cervical cancer. While HPV itself doesn’t cause infertility, the consequences of cervical cancer and its treatment can. For example, a biopsy to analyse abnormal cervical cells can slightly increase the risk of cervical narrowing (also called cervical stenosis). This makes the environment difficult or even impossible for sperm to pass through the cervix, and dilation may be required.
More invasive cancer treatments, such as chemotherapy or radiotherapy, may affect the ovaries and hormone levels, potentially impairing fertility. Women undergoing treatment are encouraged to explore fertility preservation options such as egg freezing before starting cancer therapy.
Pelvic Inflammatory Disease (PID)
PID is not an STI in itself, but it often develops as a result of untreated infections, particularly chlamydia and gonorrhoea. It’s an infection of the female reproductive organs, including the uterus, fallopian tubes and ovaries, and it can lead to long-term damage if not diagnosed and treated promptly.
PID may cause few or no symptoms in its early stages, which means many women don’t realise they have it until complications arise. When symptoms do occur, they may include pelvic or lower abdominal pain, unusual vaginal discharge, painful intercourse, fever or irregular bleeding.
One of the most serious consequences of PID is its impact on fertility. The condition can lead to scarring of the fallopian tubes, making it more difficult for an egg to travel from the ovary to the uterus. This raises the risk of infertility, as well as complications like ectopic pregnancy, where a fertilised egg implants outside the womb.
Fortunately, if caught early, PID can usually be treated with a course of antibiotics. In more advanced cases, hospital treatment or surgery may be needed. When it comes to fertility, IVF may be required for successful conception.
How to protect yourself against STIs
Practising safe sex reduces the risk of contracting STIs and helps prevent complications that could affect your ability to conceive later on.
Barrier method contraception
Condoms remain the most reliable barrier method for preventing the spread of most STIs, including chlamydia and gonorrhoea. This applies to both vaginal and anal sex. If you’re sharing sex toys with your sexual partner, always clean them thoroughly between uses, or use a fresh condom on the toy to avoid transmission.
Regular testing
It’s also important to communicate with partners about sexual health. If you’re beginning a new relationship, consider asking your partner to get tested, and get tested yourself. Ideally, testing should be carried out each time you have sex with someone new, as many STIs don’t show symptoms right away. Regular screenings are particularly important if you’re sexually active with multiple partners.
How to handle your sexual health when trying to conceive
If you’re trying for a baby, it’s vital to make your sexual health a priority. If you’ve been trying to conceive without success, it’s wise to include a sexual health screening as part of your fertility checks. Encourage your partner to get tested too, as fertility challenges can stem from either side.
When speaking to your fertility consultant, it’s important to be open about your sexual health history, even if it feels uncomfortable. At The Fertility & Gynaecology Academy, we offer a discreet and non-judgemental service, and the more you can tell us, the better we can help. Your input enables us to recommend the right tests and treatments, potentially saving time and unnecessary stress.
It’s also worth remembering that while many STIs are treatable, some – like herpes – currently have no cure. Managing these conditions effectively can still allow you to conceive and have a healthy pregnancy, but early awareness and medical support are key.
To find out more, call The Fertility & Gynaecology Academy now on 020 7224 1880 or email info@fertility-academy.co.uk.
