Infection and Infertility

The Role of Infection in Infertility

How Infection Affects Fertility

• Infections cause inflammation, which can impact both male and female reproductive health.
• Early detection and treatment are critical to preventing irreversible structural damage.

Testing for infectious agents in both men and women is essential for managing infertility.

Female Infertility and Infections

Key Facts About Infection-Related Female Infertility

• Infection of the fallopian tubes affects ~15% of women of reproductive age.
• Approximately 2.5% of affected women will become infertile by age 35.
• The most important sexually transmitted infections (STIs) linked to female infertility include:
  • Chlamydia trachomatis.
  • Neisseria gonorrhoeae.
• Other infections contributing to infertility and adverse pregnancy outcomes include:
  • Bacterial vaginosis (BV).
  • Trichomoniasis.
  • Candidiasis.
  • Genital Mycoplasma infections.

Untreated infections increase the risk of acquiring HIV and can lead to permanent reproductive damage.

Male Infertility and Infections

Key Facts About Infection-Related Male Infertility

• Infections of the male genito-urinary tract account for ~15% of male infertility cases.
• Infections can affect:
  • Testes.
  • Epididymis.
  • Accessory sex glands.
• Impact on sperm health:
  • Interferes with sperm development, maturation, and motility.
• Major sexually transmitted causes of male infertility:
  • Chlamydia trachomatis.
  • Neisseria gonorrhoeae.
• Non-STI causes:
  • Non-sexually transmitted epididymo-orchitis can also lead to infertility.

Infections can be asymptomatic in men and women, making early testing crucial.

Why Testing for Infections is Important

Key Reasons for Testing

• Men and women of all ages can be tested.
• Testing is necessary for both symptomatic and asymptomatic individuals.
• Early testing enables timely treatment to prevent infertility.
• Test results are available within 72 hours.
• Medical aid schemes may cover the cost (partially or fully).

Once structural damage occurs in the reproductive tract, it may be irreversible—early diagnosis is key.

Available Infection Testing Options at Ampath

Microscopy and Culture

• Specimen types: Vaginal swab, urethral swab, semen.
• Detects:
  • Bacterial vaginosis (BV).
  • Neisseria gonorrhoeae.
  • Other bacteria associated with genital infections.
  • Candidiasis.
  • Trichomonas vaginalis.

Bacterial Vaginosis PCR

• Specimen type: Dry vaginal swab.
• Detects:
  • Lactobacillus species.
  • BV-associated bacteria.
  • Candidiasis.
  • Trichomonas vaginalis.

Sexually Transmitted Infections (STI) PCR

• Specimen types: Urine and genital swabs.
• Detects:
  • Chlamydia trachomatis.
  • Neisseria gonorrhoeae.
  • Mycoplasma genitalium.
  • Mycoplasma hominis.
  • Ureaplasma urealyticum.
  • Ureaplasma parvum.
  • Trichomonas vaginalis.

Genital Ulcer Multiplex PCR

• Specimen types: Genital ulcer swabs, bubo aspirate, rectal swabs.
• Detects:
  • Herpes Simplex Virus (HSV-1, HSV-2).
  • Varicella-Zoster Virus (VZV).
  • Cytomegalovirus (CMV).
  • Treponema pallidum (syphilis).
  • Haemophilus ducreyi (chancroid).
  • Chlamydia trachomatis serovars L1–3 (lymphogranuloma venereum).

Timely testing and treatment can prevent infection-related infertility and improve reproductive health outcomes.