The presence of a sexually transmitted disease (STD) does not typically prevent a person from becoming pregnant. STDs are infections caused by bacteria, viruses, or parasites passed through sexual contact. Conception, the biological process of a sperm fertilizing an egg, remains physically possible even when an infection is present. While the ability to conceive is generally unaffected, the infection can introduce serious complications for both the person carrying the pregnancy and the developing fetus. Medical guidance and early screening are highly recommended for anyone with an active STD who is planning a pregnancy or has recently become pregnant.
How STDs Affect the Ability to Conceive
The long-term impact an STD has on a person’s ability to conceive depends heavily on the specific type of infection and whether it was treated promptly. Untreated bacterial STDs, specifically Chlamydia and Gonorrhea, are the primary causes of structural damage that can impair fertility. These infections can ascend from the lower reproductive tract into the uterus, fallopian tubes, and ovaries, leading to a condition known as Pelvic Inflammatory Disease (PID).
PID causes inflammation and scarring within the reproductive organs. This scar tissue can partially or completely block the fallopian tubes, which is a common cause of tubal factor infertility. When the tubes are blocked, sperm cannot reach the egg for fertilization, physically preventing conception.
The damage can also increase the risk of an ectopic pregnancy, where a fertilized egg implants outside the uterus, most commonly in a scarred fallopian tube. Ectopic pregnancies are not viable and pose a severe health risk to the mother. Viral STDs, such as Human Papillomavirus (HPV) or Herpes Simplex Virus (HSV), do not directly cause this structural damage. While procedures to treat HPV-related cervical changes can sometimes affect fertility, the infection itself does not typically block the physical pathway needed to get pregnant.
Health Risks During Pregnancy
While many people with STDs can conceive, the infection poses significant risks once a pregnancy is established. Health consequences for the mother can include premature rupture of membranes and an increased risk of preterm labor (labor occurring before 37 weeks of gestation). Furthermore, an untreated STD can make the mother more susceptible to other serious infections, such as opportunistic infections if the immune system is compromised by HIV.
A major concern is vertical transmission, the passing of the infection from the mother to the fetus or newborn. This transmission can occur across the placenta during gestation, through contact with infected genital secretions during birth, or after birth via breastfeeding.
Syphilis, a bacterial infection, is particularly dangerous because it can cross the placenta and infect the fetus during development. This can lead to severe outcomes like congenital syphilis, stillbirth, or brain damage.
Other infections, including Gonorrhea, Chlamydia, Hepatitis B, and Genital Herpes, are primarily transmitted to the baby as it passes through the birth canal. For example, exposure to Herpes Simplex Virus during delivery can develop neonatal herpes, a serious condition that affects the central nervous system. For a mother with HIV, the virus can be transmitted during pregnancy, labor, or through breast milk, making specialized medical management necessary to protect the baby. The potential consequences for the newborn include low birth weight, pneumonia, blindness, and neurological impairment.
Treatment and Prevention Strategies
Proactive screening and treatment are the most effective ways to mitigate the risks associated with STDs during pregnancy. Comprehensive prenatal care typically includes screening for infections such as HIV, Syphilis, and Hepatitis B at the initial visit. Screening for Chlamydia and Gonorrhea is also routinely recommended, particularly for women under the age of 25 and those with increased risk factors.
Bacterial infections like Syphilis, Chlamydia, and Gonorrhea are curable with antibiotics safe for use during pregnancy. Treatment of these bacterial infections early significantly reduces the chance of transmission to the fetus and prevents permanent damage. Viral STDs, such as HIV and Genital Herpes, are not curable but are manageable during pregnancy to protect the baby.
For women with HIV, a regimen of antiretroviral therapy can suppress the viral load to undetectable levels, reducing the risk of transmission to the baby to less than one percent. Women with a history of Genital Herpes may be given antiviral medication starting around 36 weeks of gestation to prevent an outbreak near delivery. If a person has an active Herpes outbreak or a high HIV viral load near their due date, a Cesarean section may be planned to prevent the newborn from contacting the virus in the birth canal.