July 13, 2017

Bacteria Can Be A Factor In Infertility

Globally, approximately 10% of reproductive-age women are afflicted with infertility. There are multiple factors (and sometimes in combination) at play: endocrine (the signals coordinating), uterine (the temporary home), the fallopian tubes (the highway and meeting place for egg and sperm), and the eggs and sperm themselves. Bacteria can be a factor in infertility.

Tubal factor infertility accounts for almost one-third of female infertility in the U.S. Such infertility can be the result of the tubes being immobilized (pelvic adhesions restricting their movement), or salpingitis (essentially potholes on this highway). Both can impair and prevent egg and sperm meeting and thus embryo creation. The egg normally is fertilized in the fallopian tube. The embryo transits down the fallopian tube as it divides and traverses into the awaiting endometrium. As can be imagined, potholes and travel obstructions impede travel and thus can promote implantation not in the uterus (ectopic pregnancy).

Who lies culprit to these roadblocks both in the pelvis and in the fallopian tubes? If the cause is bacterial, it most often is from ascension of the bacteria from the vagina into the cervix, the endometrium and into the tubes. Bacteria can flow into the pelvis and cause acute pelvic inflammatory disease (PID). Often these conditions are symptomatic, but the presence of the bacteria may go undetected. The majority of women with tubal factor-infertility do not have a history of clinically-diagnosed PID, but have been affected by an infection of the upper genital tract.

There are a few sexually transmitted disease that are almost synonymous with PID – Chlamydia trachomatis, and Neisseria gonorrhoeae (Chlamydia and Gonorrhea). However, data emerges on other culprits – Trichomonas vaginalis and Mycoplasma genitalium as well as other microbes in the vaginal microbiome. However, not all bacteria, pathogens and co-infections result in tubal factor infertility and subsequent infertility.

The importance is prevention of exposure and screening and take an active role in your gynecologic care. If you have questions, please contact us. We are here for you!

 

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Danielle Vitiello, Ph.D., M.D. Board-Certified in Obstetrics and Gynecology, Reproductive Endocrinology and Infertility