Sexually transmitted infections (STIs) are very common, and many cause no symptoms. Some, especially chlamydia and gonorrhoea, can spread to the womb and fallopian tubes if untreated. Testing is quick, treatment works, and looking after your sexual health is a normal part of planning a family.
Why STIs matter for fertility
WHO describes chlamydia and gonorrhoea as major causes of pelvic inflammatory disease and infertility in women. Infection can travel up from the cervix to the womb, tubes and ovaries.
The fallopian tubes are where egg and sperm meet. Scarring can block them, preventing pregnancy or raising the risk of an ectopic pregnancy, where a pregnancy grows outside the womb.
The CDC notes that about 1 in 8 women with a history of PID have difficulty getting pregnant.
Common infections to know about
| Infection | Key facts |
|---|---|
| Chlamydia | Most people have no symptoms; can cause PID, tube scarring and infertility; curable with antibiotics |
| Gonorrhoea | Women often have no symptoms; can cause PID; drug-resistant strains are increasing |
| Syphilis and trichomoniasis | Also curable with antibiotics, so testing and treatment are worthwhile |
| Hepatitis B and HPV | Viral STIs that can be prevented by vaccines |
In men, chlamydia and gonorrhoea can cause painful inflammation near the testicles, which rarely affects fertility. Both partners matter.
Signs of pelvic inflammatory disease
PID can be mild or cause no symptoms. When present, signs may include:
- Pain in the lower abdomen or pelvis
- Pain during sex
- Unusual vaginal discharge, sometimes with an odour
- Bleeding between periods or after sex
- Fever or a burning feeling when passing urine
PID is usually treated with antibiotics. Early treatment can prevent complications, so see a doctor promptly if you have these symptoms.
Testing, treatment and partners
- Get testedA urine test or swab checks for chlamydia and gonorrhoea. It is quick and confidential.
- Finish treatmentTake every dose prescribed. Avoid sex until treatment is finished, as your doctor advises.
- Treat partners tooPartners should be tested and treated so the infection is not passed back.
- RetestReinfection is common. The CDC suggests testing again about 3 months after chlamydia treatment.
Testing for chlamydia and gonorrhoea usually uses a urine sample or a swab. Depending on your sexual history, the CDC notes a throat or rectal swab may also be taken, since infections there can also go unnoticed.
The CDC recommends yearly chlamydia and gonorrhoea testing for sexually active women under 25, and for older women with new or multiple partners.
More about PID and prevention
PID is most often caused by untreated chlamydia or gonorrhoea, but the NHS notes it can also follow other bacteria, for example after a miscarriage, a procedure on the cervix or fitting an IUD.
Treatment usually starts with an antibiotic injection followed by about two weeks of antibiotic tablets, with pain relief if needed. Early treatment helps, but damage to the tubes cannot be reversed.
The CDC says the surest prevention is not having sex; otherwise, a long-term relationship with a tested partner and consistent condom use lower risk.
Protecting your fertility
- Use condoms correctly and every time with new partners
- Test before trying for a baby, and both of you if possible
- Ask about hepatitis B and HPV vaccines
- Mention any past STI or PID to your fertility doctor
- Assume no symptoms means no infection
- Stop antibiotics early or share them
- Douche, which can raise PID risk
If you have had PID or an STI and are trying to conceive, your doctor may check whether your tubes are open. Options include an HSG (an X-ray with dye), a HyCoSy (an ultrasound with fluid) or laparoscopy (keyhole surgery with a camera).
Sexual health is health. Doctors see these infections every day, and asking for a test is a responsible, caring choice.
Chlamydia testing at a glance
Chlamydia often causes no symptoms, so testing is the only way to know. Untreated, it can lead to PID, scarred tubes, ectopic pregnancy and infertility.
| Who | CDC testing advice |
|---|---|
| Sexually active women under 25 | Every year |
| Women 25 and over | Every year if new or multiple partners, or a partner with an STI |
| Gay and bisexual men | Every year |
| After treatment | Retest about 3 months later, even if partners were treated |
- After single-dose treatment, wait 7 days before sex; after a 7-day course, wait until it is finished.
- PID is usually treated with an antibiotic injection then about 2 weeks of tablets.
- Avoid sex until you and your partner have both finished treatment and symptoms have gone.
Questions to ask at your visit:
- Which STI tests do my partner and I both need before trying?
- If I have had PID, should my fallopian tubes be checked?
- When should I be retested after treatment?
- How can my partner get tested and treated at the same time?
Seek emergency care for severe pelvic pain, heavy bleeding, dizziness or a high fever.
When to see a doctor
- You have pelvic pain, pain during sex or unusual discharge
- A partner tells you they have an STI
- You have a new partner and have not been tested
- You have had PID or an STI before and are planning a pregnancy
- You are pregnant and have pain or bleeding
Questions & answers
If I had chlamydia in the past, can I still get pregnant?
Many people can. If it is taking time, a test of your tubes can show whether there is any blockage.
Can blocked tubes be treated?
It depends on the damage. Some cases can be assessed or treated with keyhole surgery, and IVF bypasses the tubes.
Does my partner need testing too?
Yes. Treating both partners prevents passing the infection back and forth.
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Sources
- Sexually transmitted infections (STIs) fact sheet — World Health Organization
- About Pelvic Inflammatory Disease (PID) — CDC
- About Chlamydia — CDC
- About Gonorrhea — CDC
- Pelvic inflammatory disease — NHS
- Infertility: diagnosis — NHS