He never called. The sex wasn’t that great, anyway. If you have a few youthful indiscretions in your past, or simply a new partner with a nasty surprise, you might be one of the 87 million people with a new case of sexually transmitted infection or disease. And you might not even know it. It could be the reason you’re having problems getting pregnant.

The culprits

Chlamydia and gonorrhea

Chlamydia and gonorrhea are the most important preventable causes of infertility. An estimated 2.8 million cases of chlamydia and 718,000 cases of gonorrhea occur annually in the United States. Most women infected with chlamydia or gonorrhea have no symptoms.

According to the Centers for Disease Control, untreated, up to 40% of women with chlamydia or gonorrhea will develop pelvic inflammatory disease (PID), or chronic infection. PID causes damage to the fallopian tubes, and once this has occurred it is not usually reversed by treatment. It can lead to infertility and potentially fatal tubal (ectopic) pregnancy.

Pelvic Inflammatory Disease

As Dr. Elizabeth Boskey explains, “pelvic inflammatory disease is, essentially, caused by the body overreacting to an infection. As the immune system tries to fight off the invading bacteria, it causes local inflammation and scarring. Although this may successfully wall off the infection inside the reproductive tract, it can be damage the organs.”

A woman with PID may not always have symptoms. However, the symptoms of PID can include: lower abdominal pain and/or lower back pain, longer and/or heavier menstrual periods, cramps or spotting throughout the month, unusual vaginal discharge (change in smell, color, or amount), tiredness, weakness, fever, vomiting, nausea, pain during sex, pain or burning when urinating

HPV

Women with the human papillomavirus (HPV) were less than half as likely to become pregnant after using IVF than women without the infection. Researchers Steven D. Spandorfer, MD, of the Center for Reproductive Medicine and Infertility at New York Hospital-Cornell Medical Center, explain, “women seeking infertility treatment who are in a monogamous relationship may have an impaired immune system that is unable to clear the HPV virus. This may also make it more difficult for embryo implantation to occur.”

There is no treatment or cure for HPV, although a new vaccine to prevent HPV transmission is now available. Jenny Kovacs of WebMD explains, “the vaccine is recommended for girls and women age 9 to 26 years. The vaccine prevents transmission of four of the most dangerous strains of the virus. These four strains are responsible for 70 percent of all cervical cancers and 90 percent of genital warts.”

HIV/AIDS

Between 1999 and 2003, the estimated number of AIDS cases increased 15 percent among women and only 1 percent among men, according to a report from the CDC.

Symptoms include extreme tiredness; rapid weight loss; fevers and night sweats; long-lasting infections; diarrhea; swollen glands; coughing; oral and vaginal yeast infections; pelvic inflammatory disease (PID); menstrual cycle changes; red, brown, or purplish blotches on the skin or inside the mouth, nose, or eyelids.

Syphilis

Fairly easily treated with antibiotics in its early stages, syphilis can create some real damage if left unchecked. Effects of late stage syphilis, which can surface years later, range from gradual blindness to paralysis and dementia. Eventually, untreated syphilis can lead to death. While syphilis in its early stages may not impair a woman’s ability to get pregnant, syphilis can be devastating to the children born of infected women.

To Prevent STD’s

The National Institute of Allergy and Infectious Diseases suggests the following to reduce your risk of developing a sexually transmitted disease:

• have a mutually monogamous sexual relationship with an uninfected partner
• use (consistently and correctly) a male condom
• use sterile needles if injecting intravenous drugs
• decrease susceptibility to HIV infections by preventing and controlling other STDs
• delay having sexual relationships as long as possible – the younger a person is when they begin to have sex for the first time, the more susceptible they become to developing an STD
• have regular checkups for STDs
• learn the symptoms of STDs and seek medical help as soon as possible if any symptoms develop
• avoid having sexual intercourse during menstruation
• avoid anal intercourse, or use a male condom
• avoid douching

If it’s too late for prevention – what’s a girl to do?

First, the bad news – STD’s will not go away on their own. You need to know if you have one, and if so, which one. Plus, going in for an annual Pap isn’t going to cut it. A Pap test is not a test for STDs. Ask your health care professional specifically for an STD screen.

“Because many STDs are asymptomatic, annual screening of sexually-active women aged 20 to 25 years is recommended by the CDC as is screening of older women with risk factors (such as a new sexual partner),” explains Dr. Hollier guest editor of Obstetrics and Gynecology Clinics of North America-Infectious Disease and Women’s Health.