We think about 10% of all women are infertile. Infertility can be due to factors of your hormones, your vaginal health, your cervix, the uterus itself, the fallopian tubes, or factors in the pelvic cavity. About 30% of the women who are infertile are infertile because of blocked fallopian tubes.
Most cases of tubal disease causing infertility are due to the consequences of getting STDs gonorrhea or chlamydia. After the initial infection with an STD organism in the vagina or cervix, it causes spread of infection to the fallopian tubes, which is also known as Pelvic Inflammatory Disease, or PID. It’s the body’s reaction to the infection that causes inflammation, and eventual a reaction that is so intense it can cause internal or external tubal scarring.
It is not just GC, and CT which are commonly screened for that can cause tubal disease. Increasingly we see that tubal disease is due to an organism most women have never heard of. It is not just bacteria even the protozoa Trichomonas vaginalis can cause tubal disease.
We’ve known about gonorrhea since the 1870’s and Noggerath’s work! Chlamydia trachomatis is responsible for over 50% of tubal disease. At Women‘s Health Practice we can draw a blood test to see if you have had exposure to this condition.
Another organism that is not screened for and not widely heard of Mycoplasma genitalium is looming to become the most serious STD that can lead to Pelvic Inflammatory Disease (PID) and subsequent tubal disease. About 15% of all cases of PID will cause tubal factor infertility. Men can get it and it can be a cause of urethral infection in men. . It’s difficult to test for, and not susceptible to the same antibiotics that treat Chlamydia or gonorrhea. What is most worrisome to gynos is that it’s thought that resistance to the antibiotic that is currently effective, moxifloxacin, is going to develop very rapidly. Even asymptomatic mycoplasma organism, is popping up so frequently researchers out of Sweden have discovered it’s almost as common as chlamydia. This bug can Mycoplasma can also cause infections of the cervix called cervicitis, or infections associated with pregnancy such as infection after termination, delivery or miscarriage.
Come in for evaluation of unusual discharge, odor, irritation, pelvic pain, or pain with intercourse. It is important you keep your vaginal canal in a healthy balance. This may mean preventative treatments to help keep the healthy lactobacilli functioning so that pathological organisms stay suppressed. Untreated infections can put you at risk for future pelvic pain, infertility, tubal pregnancies and pregnancy loss. Both the consequence of pelvic pain, any association with miscarriage, and infertility can be prevented if caught in the early stages and treated.The catching it is the problem, as there are actually no FDA approved tests for the organism, so you may want to check with your gyno about what laboratory she’s using and how she best help you be monitored.
The newest evidence is that over 12 research studies have showing that Bacterial Vaginosis, also called BV, is linked to infertility. At lease 1 in 5 women that are infertile have BV. Not only that but BV can infect the fallopian tubes, not just be confined to the lower genital tract according to a review in the American Journal of Obstetrics and Gynecology in January 2017. And one in 3 women with infertility has an abnormal vaginal microflora.
Even with appropriate testing 15% of all women with infertility may not have a ‘real explanation.’ For those women we advise fertility treatments, and often they are successful, even it there is not infection nor tubal blockage or a firm diagnostic reason that ovulation is the cause of the infertility to begin with.