Chlamydia and fertility

by Dr Howard Lee

I have been trying to get pregnant for nine months with no success. I am 30 and my husband is 35. Approximately seven years ago, before I met my husband, I was diagnosed with STD Chlamydia. The symptoms were 'a discharge and unpleasant odour'. I was prescribed antibiotics, but foolishly stopped taking them when the symptoms disappeared (probably only half the prescribed course). I then got on with my life and the symptoms never returned so I never went back to the clinic.

About 18 months ago and while I was still on the Pill, I started having slight spotting (breakthrough bleeding). It usually happened a couple of days after my period. I visited my GP and, although she changed my contraceptive Pill twice, it still happened. I have now been off the pill for nine months and I still get the breakthrough, which has now happened mid-cycle along with a tingling/smarting sensation, which isn't going away. I'm worried that I've still got the chlamydia, or that it could now be PID - Pelvic Inflammatory Disease.

I have booked an appointment for a test, but I'm worried that I may have a blocked fallopian tube due to this (long term) infection. Is it possible to unblock them? I have explained all this to my husband who has been understanding. The only symptom he has ever experienced is a slight tingling sensation in his testicle now and again.

answer

Your account of your menstrual pattern seems to support an 'ovulation' pattern which is encouraging. One of the most important questions to ask would be if either you, or your husband, have had any children: either in your current relationship or a previous one? Some people - male and female - can be very fertile, some not so fertile. Do we know that your husband has, in fact got sperms available? In about 20 cases per 100 there is a male factor involved in 'infertility'.

As far as the chlamydia is concerned, this infection is very common in young women - 1 in 12 between the ages of 16 and 24 years has the infection and it's on the increase. Up to 70% of the cases are in women without symptoms, as you mentioned, and untreated infections may persist for months.

The risk of infertility following a single episode is hard to estimate. If a woman suffers inflammation within the tubes or the pelvic organs (PID or Pelvic Inflammatory Disease), then around 17% of these will become infertile. Up to half of these cases are caused by chlamydia. Scarring of the tubes, which will influence fertility, can be helped in some instances with surgery - so don't be too despondent. You should go for tests to determine whether you have a chlamydia infection, and to look for 'tube scarring' from your past infection. I do wish you both success in your efforts. For more information - look at our article on Chlamydia.

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Chlamydia and fertility