Female fertility problems, including those related to fallopian tube disorders, are increasing in prevalence and are major health concerns worldwide.

Most cases related to tubal causes of infertility are associated with sexually transmitted diseases (STDs) that ascend the reproductive tract, resulting in tubal inflammation, scarring, and damage.

Various studies have shown that chlamydia affects the reproductive tract and causes pelvic inflammatory disease and tubal factor infertility.

So, yes, chlamydia can affect fertility in women. Let us understand more about it.

How Chlamydia Affects Fertility?

Before going ahead, it is essential to briefly understand infertility.

Infertility is a condition where a couple is unable to conceive after at least 12 months of unprotected sexual intercourse.

Female causes are responsible for about one-third of all infertility cases, and globally, every one in ten women of reproductive age is infertile.

Various factors, including vaginal, uterine, tubal, endocrine, and pelvic, are responsible for female infertility. 

Tubal factor fertility (TFI), which is infertility due to tubal disorders, is the most common cause, accounting for 30% of all female infertility cases.

The majority of the TFI cases are due to inflammation of the fallopian tubes (salpingitis) and adhesions of the abdominals’ lining with the pelvic organs.

Chlamydia infection and infertility

Chlamydia is a common sexually transmitted infection, and its prevalence is on the rise in Canada. It can be spread during anal, oral, or vaginal sex. Besides, an infected mother can also pass the disease to the baby during delivery.

While any sexually active person can get chlamydia, its risk increases with a greater number of sexual partners. The infection is more common in sexually active women between 18-24 years.

Most women with chlamydia infection do not have any symptoms; however, when present, the symptoms include a burning sensation when urinating and abnormal vaginal discharge.

As most cases of chlamydia in women are asymptomatic, the infection goes unnoticed, and untreated ascending chlamydia infection can result in irreversible fallopian tube damage, resulting in infertility. 

In untreated chlamydia, bacteria can travel from the cervix to the fallopian tubes, resulting in pelvic inflammatory disease (PID), which may ultimately cause TFI. Chlamydia is responsible for 50% of the PID cases.

It is seen that about 15% of women with PID develop infertility. Besides, the higher the episodes of PID, the greater is the risk of infertility.

Studies have shown that bacteria responsible for the chlamydia infection release heat shock protein, inducing a pro-inflammatory response, resulting in tubal occlusion and scarring.

Complications Caused

As mentioned before, untreated infection can spread the fallopian tubes, blocking them at the very end. This condition is known as hydrosalpinx. The infection can also cause scarring around the tubes, making it difficult for them to pick up the egg during ovulation. This can result in ectopic pregnancy or infertility.

The commonest complication of chlamydia in women is a pelvic inflammatory disease.

Pelvic inflammatory disease (PID)

If the infection spreads to the ovaries, fallopian tubes, or the uterus, it can cause PID.

PID can cause the following problems:

  • A long-standing pelvic pain
  • An increased risk of ectopic pregnancy 
  • Infertility or difficulty in getting pregnant

Some common symptoms of PID include:

  • Pain or discomfort during sex
  • Bleeding between periods
  • Bleeding after sex
  • Pain during urination

Fortunately, PID can be managed with two weeks course of antibiotics. And the risk of complications, including infertility, is also lower if picked up and treated early. So, it is a good idea to screen yourself and get tested if you have symptoms of chlamydia.

Detection

The most common and best way to detect chlamydia is taking a swab from the cervix during a speculum exam. This swab is tested for DNA. The only drawback of the test is that it cannot tell the doctor how old your infection is or the severity. It can also miss an infection that has moved up to the tubes or uterus and not present in the cervix.

Another good test for detecting this infection is through a blood test to detect chlamydia antibodies. It is also a good indicator of tubal blockage.

However, higher levels of chlamydia antibodies do not necessarily mean active infection. It just means that the woman was exposed to the bacteria. 

C reactive protein (CRP), a blood test, can also help to detect inflammation. Studies have shown that high CRP and positive chlamydia antibody test has an increased risk of finding tubal disease.

A procedure known as hysterosalpingogram can also help detect distal tubal obstruction. However, pelvic adhesions can only be picked up during laparoscopy. It is a surgical technique that involves inserting an instrument through a hole made in the abdomen to look at the internal organs and is done under general anesthesia.

Treatment

The good news is that chlamydia can be cured easily. It is seen that 95% of the infected individuals are cured of the infection if they take medicines correctly. 

As chlamydia is a bacterial infection, antibiotics help to manage it. Commonly used antibiotics are:

  • Azithromycin: Usually prescribed to be taken in a single large dose
  • Doxycycline: To be taken twice a day for a week

If you are allergic to the mentioned medicines or are not advisable for you, the doctor may prescribe other antibiotics such as erythromycin or amoxicillin. So, do not take medicine before consulting your doctor.

Despite the choice of antibiotics, taking medicine correctly will ensure that the infection is cleared completely. It may take up to two weeks for the same.

Your doctor will advise refraining from sex during treatment to prevent the spread of the infection to your partner. It is also possible to get or spread the infection if you are exposed to the bacteria again, even if you are treated for your previous infection.

Precautions

The surest and the best way to prevent spreading or contracting chlamydia infection is to use a condom during sex.

It is recommended to:

  • Use a condom, especially with each new partner
  • Avoid having oral sex unless the partner is screened for STIs
  • Get screened regularly
  • Limit the number of sexual partners
  • Correct and consistent use of condoms
  • Avoid sex until the treatment is complete
  • Get tested if you are pregnant or planning to conceive

To reduce the risk of transmitting and contracting chlamydia, avoid sexual intercourse until you complete the treatment.

Final Thoughts

Chlamydia is a common sexually transmitted disease and its prevalence is on the rise in Canada. An untreated infection may cause the bacteria to travel from the vagina to reach the tubes, causing inflammation. 

This inflammation may result in scarring and a lower risk of picking up the egg during ovulation. All this may affect your fertility. 

Fortunately, chlamydia can be treated with antibiotics. So, get screened and consult your doctor for the same to lower the risk of chlamydia-related complications, including infertility.

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