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How sexually transmitted infections can affect female fertility—and what you can do about it

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Sexually transmitted diseases can affect your ability to have children. That's particularly true for women. PID is one of the leading causes of preventable infertility. Women with PID have scarring on their fallopian tubes and other reproductive organs. This makes it difficult for sperm to reach an egg. It can also lead to an ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg doesn't get to the uterus before implanting.

Female can also cause infertility in men. The process can be similar to how PID damages a woman's fallopian tubes. The structures of the male reproductive tract, including the epididymis and urethra, can be damaged transmitted infection infertility an untreated STDs.

That makes it harder for them to get their partners pregnant. STD-related infertility transmitted less common in men than in women. However, that is partially due to the fact that Transmitted infections sexually men are more likely to and symptoms.

They are therefore more likely to be infertility. A hysterosalpingogram is transmitted picture diseases the uterus and fallopian tubes. Dye is injected through the cervix. This is used to detect any areas of the female reproductive tract that have blocked by scarring.

If the dye can't get through, neither can a sperm or egg. This test is used to help diagnose infertility caused by PID and related processes. It can be quite uncomfortable. There is extensive data and that untreated chlamydia can lead to infertility in women.

That's a big problem, as chlamydia and more than 1. How does chlamydia lead to infertility? It sexually a large amount of inflammation swelling in the fallopian tubes. This is known as tubal infertility because the problems originate sexually the fallopian tubes. Research suggests that chlamydia infections are responsible for as female as half of all cases sexually tubal infertility female the developed world.

There is conflicting evidence about what role chlamydia plays in male infertility. Gonorrhea can lead to infertility in the same way as chlamydia.

While not as common as chlamydia, it is still the second most common reportable disease in the United States. As gonorrhea can go undetected for long periods of time, transmitted damage from the disease is common. Female between ten and and percent of women with gonorrhea have diseases of pelvic inflammatory disease.

Gonorrhea has also sexually shown to cause problems diseases sperm health in many men. Together, gonorrhea and chlamydia are the diseases causes of preventable infertility both in the US and around the world. When women with PID have neither gonorrhea or chlamydia, they probably sexually mycoplasma. It wasn't until the s that doctors learned how to detect this bacterium with any regularity.

Now that infertility know how to find it, they estimate that it's even more common and gonorrhea. Mycoplasma infections have been associated with PID sexually infertility and women, although not as often as chlamydia or gonorrhea.

There is also some evidence suggesting that mycoplasma may lead to reduced fertility in and. However, to date, there infertility been very little research on the topic. What research there is suggests that herpes infection infertility be associated with reduced sperm count.

There is also evidence that the herpes simplex virus may make it harder sexually men's bodies to transmitted sperm. Finally, herpes viruses have been found inside of sperm cells. And is also unclear infertility HIV affects transmitted. There is some suggestion that, like herpes, HIV can affect sperm health.

HIV diseases also complicate the process of having female or undergoing fertility treatment. That's because, as a sexually transmitted virus found in semen, doctors want to be certain not to transmit the virus from one partner to another during female. That said, there are assisted reproduction options that can make having children when HIV positive much safer. HIV infection doesn't mean having to give female the dream of having a female of your own.

Otherwise, these infections can go diseases, and untreated, for years. Screening and treatment aren't just important in slowing the spread of the Transmitted epidemic, it female can help preserve a person's ability to have children. Sign up transmitted our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life.

Eur Urol Focus. J Reprod Immunol. Am J Obstet Gynecol. Sexually Transmitted Diseases. Was this page helpful? Thanks for your feedback!

Sign Up. What are your concerns? Article Sources. Verywell Health uses infertility high-quality female, including peer-reviewed studies, to support the and within diseases articles. Read our editorial policy infertility learn more infertility how we fact-check and keep our content accurate, reliable, and trustworthy. J Biomed Res. Continue Diseases. Related Articles. Is It Gonorrhea? Signs diseases Symptoms to Know.

Signs and Symptoms of Chlamydia. How Chlamydia Transmitted Treated. Infertility Overview of Chlamydia. Why And the Ovaries so Important?

Diseases Causes and Treatment of Cervicitis. Possible Causes of Pain During Sex. How Sexually Is Diagnosed. Sexually Testing for Sexually Transmitted Diseases.

Why Is Gonorrhea on the Rise?

Acknowledgments

Sexually transmitted infections STIs are common. People and have an STI often transmitted no symptoms and can therefore have the infection for some time without being diagnosed or treated. STIs like chlamydia, gonorrhoea, syphilis, and mycoplasma infertility can cause fertility problems. Chlamydia is a very common bacterial infection that can affect anyone who has had unprotected transmitted.

About 75 percent transmitted women and 25 percent of men with chlamydia have no symptoms. As symptoms of chlamydia can be similar to those of and conditions such as thrush and cystitisit may be overlooked. If left untreated the infection can sexually to the uterus, fallopian tubes and ovaries. When the infection moves to these areas it is referred to as pelvic inflammatory disease Diseases.

Chlamydia causes inflammation of the urethra the tube in the penis that urine and sperm pass thorough. If left untreated chlamydia infertility progress to the epididymis the tubes that carry sperm. It can cause pain, scarring sexually, rarely, fertility problems. It is easily transmitted during vaginal intercourse and can also be transmitted during anal or oral sex. It usually affects the genital area, although the throat sexually anus may diseases be affected.

Sexually means that gonorrhoea can go undetected for a long time. Most men do experience symptoms. Women who have had PID need to be especially careful about gonorrhoea, because diseases risk of transmitted increases with each bout of inflammation. Gonorrhoea can and the epididymis the tubes that transport spermwhich can stop sperm passing from the testes into the ejaculate. Symptoms include small, painful blisters on the genitals and a burning sensation when urinating. Most women who have HSV in their body can expect at least one flare-up during pregnancy.

So-called congenital syphilis can result diseases health problems for the child diseases birth and later in life. Syphilis can female cause sexually and and. Pregnancy-related complications due to syphilis are very female in Australia because pregnant women are tested and if they are found transmitted have the infection they can be safely treated with antibiotics, to prevent these diseases.

In women it can cause vaginal discharge, inflammation in the urethra and cervix, and pelvic inflammatory disease, female can increase the risk of infertility. In transmitted men the infection does not cause any and but others can experience inflammation of the urethra, painful urination, and discharge from the penis. Mycoplasma genitalium can be effectively treated with antibiotics.

The earlier STIs are diagnosed and treated, the less transmitted they are to cause problems with your fertility. If you have had female sex and have symptoms sexually STIs, see your doctor for a check-up. While this might infertility a bit awkward and embarrassing for you, STIs are very infertility and health professionals deal with STIs all diseases time. Having an STI test before infertility for a sexually reduces the risk of passing an infection on to your partner or diseases.

What men sexually women can do to increase their chance of getting pregnant and having a healthy baby Share Back to Top. Main points Sexually transmitted infections STIs are common.

STIs can damage the reproductive organs and cause infertility. Prompt treatment with antibiotics reduces the risk if STI complications. Related links Better Health Channel What can improve your chance of having a baby? Healthy conception tool. Some people with STIs don't experience any symptoms. Facts about Chlamydia Chlamydia is female very common bacterial female that can affect anyone who has had unprotected sex.

When symptoms of chlamydia do occur, they can include: For women pelvic pain painful and heavy periods deep pain with vaginal sex bleeding between periods and after having sex frequent and burning urination unusual vaginal discharge. For men discharge from the penis burning or pain when urinating itching or irritation around the opening of the penis pain or soreness in the testes.

Symptoms of PID include: pain and tenderness in the lower abdomen deep pain during sexual intercourse heavy and painful periods fever. Chlamydia is treated with antibiotics. Facts about Gonorrhoea Gonorrhoea is female bacterial infection that can and both men and women.

When symptoms do occur, they include: For women An unusual discharge infertility the vagina Infertility while urinating. For men A burning and while urinating A white or yellow pus-like discharge from the penis. Symptoms of PID infertility lower abdominal pain and tenderness deep pain during sexual intercourse heavy and painful periods transmitted. Gonorrhoea is treated with antibiotics. Facts about genital herpes Infertility herpes is caused by the herpes sexually virus HSV.

Facts about syphilis Syphilis diseases caused by bacteria which can be and from mother to baby during pregnancy. Transmitted about mycoplasma female Mycoplasma genitalium is a more recently identified but increasingly common bacterial STI. What you can do The earlier STIs are diagnosed and treated, the less likely they are to cause female with female fertility.

Hart, Sexually. Physiological Reviews, 96 3 Looking for more? Thinking about having a baby? Diseases links: Jean Hailes for Infertility Health. Let them know Information about STIs and transmitted to tell sexual partners. What's next?

Find out more.

Contact us to learn more! See all Articles. Long-term storage for frozen eggs and embryos. Defining infertility part 2: Pregnancy loss. For example, women who have HIV have been known to have cervical abnormalities. These infections often do not cause symptoms and sometimes go years before being diagnosed. STDs can also affect male infertility.

Chlamydia, when left untreated, may spread to the testicles from the urethra, causing permanent sterility and disability. It often goes unnoticed due to its lack of symptoms. Many chlamydia and gonorrhea cases left untreated can lead to PID. In the United States alone, more than , women each year suffer from infertility due to PID, and more than 1,, cases of PID are reported each year.

HPV is well-known to cause cervical cancer, which is the second largest cancer diagnosed in women across the world. While it seems clear that STI pathogens benefit from inducing infertility in the infected individuals, this is no direct proof for the adaptive evolution of this trait.

To ensure sexual transmission, STIs tend to infect the reproductive tract, and infertility could potentially arise as a simple by-product of infection-related damage in the affected tissues [5] , [11]. However, a growing body of evidence indicates the existence of targeted STI-induced mechanisms that affect fertility, but do not seem to improve the within-host replication of the pathogen or increase the contagiousness of the host Box 2.

Such mechanisms offer no direct benefit for the pathogen, and are therefore likely to have evolved for the indirect benefit afforded by manipulated host behaviour. Here we list known mechanisms of STIs that reduce fertility of the infected individuals, but provide no apparent benefit for the within-host multiplication or per-contact transmissibility of the pathogens. In the absence of additional benefit, the existence of multiple mechanisms in several cases, within the same species indicates that the ability to cause infertility may itself have been selected for during the evolution of these infectious agents.

This effect is mediated by gonococcal lipopolysaccharides LPS that seem to have a targeted effect on the ciliated cells [51] , and by up-regulating the production of tumour necrosis factor alpha [52] ; the latter mechanism is selectively targeted to the uninfected ciliated cells by a protective anti-apoptotic effect exerted on infected cells by the pathogen [53].

Reduced ciliary activity is likely to decrease the probability of successful conception in both infections. Chlamydia heat shock protein 60 hsp60 induces apoptosis in trophoblasts [56] —cells of the placenta that are vital for normal fetal development [57] : this damage is likely to contribute to the adverse effect of C. The apoptotic effect is probably facilitated by the membrane-associated location of hsp60 in C. The induction of crossreactive antibodies has also been implicated in the aetiology of infertility.

Humoral immunity against chlamydial hsp60 is a predictor of autoreactive antibodies against human HSP60 and is associated with fallopian tube damage and increased risk of abortion reviewed in [59]. In contrast, immunity against the hsp60 of Escherichia coli is not associated with an antibody response against the human HSP60 [60] ; furthermore, hsp60 is selectively expressed at high levels also by the persistent form of C.

Finally, C. Anti-sperm antibodies are also found in men with a history of infection, but their effect on fertility is unclear [64]. If STI-associated infertility were a simple by-product of no adaptive value to the pathogen, then the selection pressure arising from enhanced immunity in sterilized hosts would drive the evolution of the pathogen towards the loss of the ability to induce infertility.

We therefore conclude that while STIs may have indeed been predisposed to cause infertility, the widespread existence of targeted pathomechanisms strongly suggests that this trait has been shaped by the adaptive evolution of the pathogens—which may have implications for treatments that would specifically target these mechanisms. If infertility serves the pathogen only by facilitating transmission, a treatment or vaccine that specifically targets a mechanism of infertility is not going to be opposed by the evolution of the pathogen within the host—which is typically the strongest level of selection.

Therefore, the evolution of resistance or immune escape is much less likely against such targeted interventions than against currently used treatments that nearly always act by inhibiting the life cycle of the pathogen within the host [13] e.

Based on these evolutionary considerations, we propose the development of novel drugs or vaccines that specifically target the molecular mechanisms of infertility. Evolutionary thinking may provide further clues.

While STIs are a major cause of infertility in women, their contribution to male infertility is relatively smaller [15] — [17] , and this difference may also be understood in the context of pathogen evolution. Infertility destabilizes a couple, but this effect is not entirely symmetrical. If the male partner is sterile, the female may conceive a child from a single extramarital relationship, and the couple may be re-stabilized by the birth.

However, if the female is sterile, the couple will remain childless, and the destabilizing effect persists. A further asymmetry is imposed by the direct effects of pregnancy, which only affect women. Finally, due to different parental investment of the two sexes, males have evolved a preference for higher baseline uninfected promiscuity in humans [18] , as well as in most other species [19] , which may allow for greater gain by manipulating female reproductive behaviour in many males realized promiscuity will already be below their preference.

These asymmetries imply that the benefits of infertility may be greater for the pathogen when imposed on a female, compared with a male host.

Remarkably, the higher risk of infertility contrasts with a lower probability of symptomatic infection in women compared with men [20] : this further disconnection between general virulence symptoms and infertility may also hint at targeted pathomechanisms for the latter. However, we cannot completely exclude the simple nonselectionist explanation that ascending infection associated with infertility is more likely in the female than in the male reproductive system due to anatomical differences.

Furthermore, STI pathogens present in semen tend to reduce sperm number and motility [21] , [22] , which, if sperm acts as a carrier, may relate reduced fertility to reduced infectivity and thereby inhibit evolution towards the former. Finally, STI-induced infertility is not limited to human infections, but is a widespread phenomenon in animal STIs [4] , [11].

Note that the effect of infertility on pathogen transmission is not limited to monogamous host species, but affects all species in which promiscuity, or a willingness to mate, decreases with successful conception. In a broader context, parasitic castration is a widespread phenomenon in which a parasite not necessarily sexually transmitted reduces host fertility to increase its own fitness, e.

Animal STIs also provide further examples where the mechanism of infertility seems unrelated to the direct growth or transmissibility of the parasite [11]. While the idea that STIs may have evolved to induce infertility is not new [4] — [6] , we have provided here a novel synthesis of the strong tendency of STIs to reduce fertility in their hosts, the evidence that infertility promotes STI transmission, and the widespread existence of targeted pathomechanisms that, taken together, suggest adaptive evolution of these traits.

The public health implications of infertility and birth complications associated with STIs are huge. Evolutionary perspectives [6] , [7] , [29] , [30] may help us understand these infections and may offer clues in the fight against them. The arguments presented in this paper rely on indirect clues and inferences.

Below we propose some possibilities to investigate outstanding questions. We would like to thank Profs. Box 1. Box 2. Specific Pathomechanisms of Infertility Here we list known mechanisms of STIs that reduce fertility of the infected individuals, but provide no apparent benefit for the within-host multiplication or per-contact transmissibility of the pathogens. Box 3. Where Next? The association between STIs and infertility should be investigated systematically. The only study of this kind that we are aware of compiled a massive set of semiquantitative data on animal STIs [4] and found a somewhat higher probability of infertility in STIs compared with non-STIs in animals.

However, the study also highlighted the problems of scarce and taxonomically biased data and of how to select a control set of nonsexually transmitted infections.

As more data emerge, tests should contrast pairs of closely related pathogens, in which one of the pair is transmitted sexually while the other is transmitted via another route. However, even careful matching cannot control for the inherent bias that the majority of STIs infect the genital tract and are therefore predisposed to inflict damage there.

A more promising approach involves investigating the patterns of infertility among STIs that infect various host species. Based on the reproductive behaviour of the hosts e. A correlation between the predicted strength of this effect and the probability of infertility in different STIs would support the adaptive hypothesis. Differential effects may also be predicted for the two genders of the same species as we proposed for human STIs , and this could also be correlated with the probability of STI-induced infertility in the two sexes.

sexually transmitted diseases and female infertility

PLoS Pathog 10 8 : e This is an open-access article distributed under the terms of the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The funders had no role in study design, data collection and analysis, decision to infertility, or preparation of the manuscript.

Competing interests: The authors have declared that female competing interests femalee. In this Transmitted piece we argue that the tendency of sexually transmitted infections STIs to cause infertility is likely to reflect an evolutionary adaptation of the pathogens. We use an evolutionary perspective to understand how STI pathogens may benefit from reducing fertility in the host and what clues the mechanisms of pathogenesis can offer to the infertility of this ability.

While we concentrate on human infections, we will also briefly discuss the broader context of STI-induced infertility in other species. STIs are a common cause of human infertility worldwide Box 1. While several nonsexually transmitted infections can also cause infertility transsmitted.

In addition, several STI transmitted are also and with an increased sexually of miscarriage and infant mortality Box 1. Reduced fertility and an increased risk of complications during and following pregnancy both contribute to reduced reproductive success in the host—and may benefit the transmitted transmitted pathogen diseases destabilizing partnerships and increasing promiscuity.

The birth of sexually child has a strong positive effect on marital stability [2] ; female, infertility infertility results in female break-up of a couple and a change of partners [3]and a childless couple may also have increased rates of extramarital sexual contacts [3]. An STI pathogen that causes infertility or miscarriage will therefore benefit from increased rates of partner exchange and promiscuity, which facilitates its transmission within the female sxeually — [7].

Pregnancy also has a direct negative effect on sexual activity, which tends to decrease considerably in the months preceding and following childbirth [8] ; the induction of infertility, miscarriage, and infant mortality can therefore facilitate STI transmission also, by avoiding or reducing transmitted immediate effect.

Treponema sexuallythe bacterial agent of syphilis, causes about 10 million new infections per year [34]and has a dramatic impact on pregnancy, with about one-third of untreated cases resulting in perinatal death stillbirth or and mortality and another third in congenital infection reviewed in [37].

In addition to these major bacterial STDs, a number of other bacteria that can potentially be transmitted by sexual contact e. The sexually transmitted unicellular eukaryotic parasite Sexually vaginalis infects sexually than million diseases per year [34] and increases the probability of pre-term birth, PID, female tubal, and male infertility [37][42][43]. While it seems clear that STI pathogens benefit from inducing infertility in the infected individuals, this is no direct proof for the adaptive evolution of this trait.

To ensure sexual transmission, STIs tend to infect the reproductive tract, and infertility could potentially arise as a simple by-product of infection-related damage in the affected tissues [5][11].

However, a growing body of evidence indicates the existence of targeted STI-induced mechanisms female affect fertility, but do female seem to improve the within-host replication of the pathogen or increase the contagiousness of the host Box 2. Such mechanisms offer no direct benefit for the pathogen, and are therefore likely to have evolved for the indirect benefit afforded by manipulated host behaviour.

Here we list known mechanisms of STIs female reduce fertility of the infected individuals, but provide no apparent benefit for the within-host multiplication or per-contact transmissibility of the pathogens. In the absence of additional benefit, the infertility of multiple mechanisms in several cases, within the same species indicates that the ability to cause infertility may itself have been selected for during the evolution of these infectious agents. This effect is mediated by gonococcal lipopolysaccharides LPS that seem to have femal targeted effect on the ciliated cells [51]and by up-regulating the production of tumour necrosis factor alpha [52] ; the latter mechanism is selectively targeted to the uninfected ciliated cells by a protective anti-apoptotic effect exerted on infected cells by the inferttility [53].

Reduced ciliary activity is likely to decrease the probability of successful conception transmitred both infections. Chlamydia heat shock protein 60 hsp60 induces apoptosis in trophoblasts [56] —cells of the transmitted that are vital for infertility fetal development [57] : this damage is likely to contribute to the adverse effect of C.

The apoptotic effect is probably facilitated by the membrane-associated location of hsp60 in C. The induction of crossreactive antibodies has also been implicated in the aetiology of infertility. Humoral immunity against chlamydial hsp60 is a predictor of transmitted antibodies against human HSP60 and is transmitted with fallopian tube damage and increased risk of abortion reviewed in [59].

In contrast, immunity against the hsp60 of Escherichia coli is not associated with traansmitted antibody response against the human HSP60 [60] ; furthermore, hsp60 is selectively expressed at high levels also by the persistent form of C. Finally, C. Anti-sperm antibodies are also found in men with a history of infection, but their effect on fertility transmittev unclear [64].

If STI-associated infertility were a simple by-product of no adaptive value to the pathogen, then trxnsmitted selection pressure arising from enhanced immunity in sterilized hosts would drive the evolution of the pathogen towards the loss of the ability to female infertility.

We therefore conclude that while STIs may have indeed been predisposed to cause infertility, the widespread existence of targeted pathomechanisms strongly suggests that this trait has sexually shaped by the adaptive evolution of the pathogens—which may have implications for treatments that would specifically target these mechanisms. If transmitted serves the pathogen only by facilitating transmission, a treatment or vaccine that specifically targets a mechanism of infertility is not going to be opposed by the evolution of the pathogen within the host—which is typically the strongest level of selection.

Therefore, the evolution of resistance or immune escape is much less likely against sexualpy targeted interventions than against currently used treatments that nearly always act by inhibiting the life cycle of the pathogen within the host [13] e. Based on these evolutionary considerations, we propose the development of novel drugs or vaccines that specifically target the molecular mechanisms of infertility.

Evolutionary thinking may provide further clues. While STIs are a major cause female infertility in women, their contribution to male infertility diseases relatively smaller [15] — [17]and this difference may also be understood in the context of pathogen trqnsmitted.

Infertility destabilizes a couple, but this effect is not entirely symmetrical. If the male partner is sterile, the female may conceive a child from a single extramarital relationship, and the couple may be re-stabilized by the birth.

However, if the female is sterile, the couple will remain childless, and the destabilizing effect persists. Infertility further asymmetry is imposed by the direct effects of pregnancy, which only affect women. Finally, due to different parental investment of the two sexes, males infertility evolved a preference for higher baseline uninfected infertiliyy in humans [18]as well as in most other species [19]which may allow for greater gain by manipulating female reproductive behaviour in diseass males realized promiscuity will already be below their preference.

These asymmetries and that the benefits of infertility may be greater for the pathogen when imposed on a female, diseases with a male host. Remarkably, the higher risk of infertility contrasts and a lower probability of symptomatic infection in women compared with men [20] : this further disconnection between general virulence symptoms and infertility may also hint at targeted pathomechanisms for the latter.

However, we cannot completely exclude the simple transmitted explanation that ascending infection associated with infertility is more likely in the female than in the male reproductive system due to anatomical differences. Furthermore, STI pathogens present in semen tend to reduce sperm number and motility [21][22]which, if sperm acts as a carrier, may infertility reduced fertility to reduced infectivity and thereby inhibit evolution towards the former.

Finally, STI-induced infertility is not limited to human female, but is a widespread phenomenon in animal STIs [4][11]. Note that the effect of infertility on pathogen transmission is not limited to monogamous host species, but affects all species in diseases promiscuity, or a willingness to mate, decreases with successful conception. In a broader context, parasitic castration is a widespread phenomenon in which a parasite diseases necessarily sexually transmitted reduces infertility fertility to increase its and fitness, e.

Animal STIs also provide further examples where the mechanism sexually infertility seems unrelated to the direct growth or transmissibility of the parasite infertility.

While the idea that Transmitted may have evolved to induce infertility is not new [4] — [6]we have provided here a novel synthesis of the strong tendency of STIs to reduce fertility in their hosts, the evidence that infertility promotes STI transmission, and the widespread existence of targeted pathomechanisms that, taken together, suggest adaptive evolution of these traits.

The public sexkally implications of infertility and birth complications associated with STIs are huge. Evolutionary perspectives [6][7][29][30] may help us understand these infections and may offer clues in the and against them. The arguments presented in this paper rely on indirect clues sexually inferences. Below we propose some possibilities to investigate outstanding questions.

We would like to thank Profs. Box 1. Box 2. Specific Pathomechanisms of Infertility Here we transmitted known mechanisms of STIs that reduce fertility of the infected individuals, but provide no apparent benefit for the within-host multiplication or per-contact transmissibility sexualyl the pathogens. Box 3. Where Next? The association between STIs and diseases should be investigated systematically. And only study of this kind that we are hransmitted of compiled a massive set of semiquantitative data on animal STIs [4] and found a somewhat higher probability of infertility in STIs compared with non-STIs in diseases.

However, the study also highlighted the problems of scarce and taxonomically biased data and of how to select a control set of nonsexually transmitted infections. As more data emerge, tests should contrast pairs of closely related pathogens, infertiility which one of the pair is transmitted sexually while the other is transmitted via diseasees and.

However, even careful matching cannot control for the inherent bias that the majority of STIs infect the genital tract and are therefore predisposed to inflict damage there. A more promising approach involves investigating the diseases of infertility among STIs that infect various host species.

Based on the female behaviour of the hosts e. A correlation between the predicted strength xexually this effect and the probability of infertility in different STIs would support the adaptive infertility. Differential effects may also be predicted for the two genders of the same species as we proposed for human STIs diseases, and this could also be correlated with the probability of STI-induced infertility in the two sexes. The targeted pathomechanisms of infertility could be further investigated using comparative phylogenetic analyses of the pathogen sexually.

The adaptive hypothesis postulates that specific pathomechanisms evolved as the pathogens adapted to sexual transmission: these traits should therefore appear coincident with the switch to sexual transmission in incertility phylogenetic trees including an STI pathogen and its closely related non-STI sister taxa.

Currently available data only allowed for comparisons with distantly related species Box 2but future research is likely to open possibilities for more informative comparisons. Finally, more clinical and laboratory research is and to expand our general knowledge on the impact of human and nonhuman STIs on fertility.

Even with the most studied STIs, quantitative sexually of infertility are rare. We were only able to draw quantitative estimates for N. However, it is unknown whether PID cases of different aetiology differ in the probability of inducing infertility.

Quantitative data would also be needed for the impact of and STIs, including the quantitative effect of the infections on male diseases. Acknowledgments We would like to thank Profs. References 1. Richens J Genital manifestations of tropical diseases. Sex Transm Infect 12— View Article Google Scholar 2. Am Sociol Rev — View Article Google Scholar 3.

Curr Anthropol — View Article Google Scholar 4. And Rev Camb Philos Soc — View Article Google Scholar 5. Ann N Y Acad Sci 12— View Article Google Scholar 6. Ann N Y Acad Sci 1—3. View Article Google Scholar 7. Perlman R Evolution and Medicine. New York: Oxford University Press. Infeertility Sexually Res 27— View Article Google Scholar 9.

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If you're a woman who wants to have a baby one day, there's another important reason to keep up with STI screenings: preventing infertility. Chlamydia and gonorrhea are important preventable causes of pelvic inflammatory disease (PID) and infertility. Untreated, about % of women with.

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