Pelvic Inflammatory Disease and Infertility

Pelvic inflammatory disease (PID) is an infection of the female upper genital tract, including the womb, fallopian tubes and ovaries. It mostly affects sexually active women aged 15 to 24.

Causes

Most cases of PID are caused by a bacterial infection that’s spread from the vagina or the cervix to the reproductive organs higher up. Many different types of bacteria can cause PID. In about 25% it is caused by a sexually transmitted infection (STI) such as chlamydia or gonorrhoea.

Symptoms

PID often doesn’t cause any obvious symptoms.

Most women have mild symptoms such as:

• pain in the tummy or pain during sex or during urination
• bleeding between periods and after sex
• heavy or painful periods
• unusual vaginal discharge, especially if it’s yellow or green

A few women may become very ill and have:

• severe tummy pain
• a high temperature
• nausea and vomiting

Complications

Tubal occlusion (blockage): Sexually transmitted infections including chlamydia, gonorrhoea, or pelvic inflammatory disease can predispose a woman to having blocked fallopian tubes. Tubal occlusion is a cause of infertility because an ovulated egg is unable to be fertilised by sperm or to reach the endometrial cavity. This can increase your chances of having an ectopic pregnancy (a pregnancy in the fallopian tubes instead of the womb) in the future and can make some women infertile. It’s estimated that around 1 in 10 women with PID becomes infertile as a result of the condition. Women who have had delayed treatment or had repeated episodes of PID are most at risk.

Treatment

If diagnosed at an early stage, PID can be treated with a course of antibiotics, which usually lasts for 14 days.
It’s important to complete the whole course and avoid having sexual intercourse during this time to help ensure the infection clears. Your recent sexual partners also need to be tested and treated to stop the infection recurring or being spread to others.

If both tubes are blocked, then in vitro fertilization (IVF) is required. If a tube is blocked and filled with fluid (called a hydrosalpinx), then minimally invasive surgery (laparoscopy or hysteroscopy) to either remove the tube or block/separate it from the uterus prior to any fertility treatments is recommended.

Prevention

You can reduce your risk of PID by always using condoms with a new sexual partner until they’ve had a sexual health check.

Frequently asked question on Infections and Infertility

Can chlamydia cause infertility?
Yes, the association of chlamydia and infertility is well recognised.

Can gonorrhoea cause infertility?
Yes, the association of gonorrhoea and infertility is well recognised.

Can HPV cause infertility?
Human Papilloma Virus infection is a risk factor for male infertility and is associated with cervical cancer in females.

Can yeast infections cause infertility?
No, yeast or candida infections are fungal infections and do not cause infertility.

Can trichomoniasis cause infertility?
No, although it is a sexually transmitted infection.

Can Bacterial Vaginosis (BV) cause infertility?
No, bacterial vaginosis does not cause infertility.

Can herpes cause infertility?
No, Herpes infections do not cause infertility.

Can burning urination cause infertility?
No, urinary tract infections are linked to miscarriages.

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