Bacterial Vaginosis (BV) is the most frequent vaginal infection in women of reproductive age. It is not a sexually transmitted infection, but an imbalance where normal, helpful bacteria in the vagina are overgrown by other types of bacteria. The answer to the primary question is straightforward: yes, you can get pregnant while having BV. While BV can affect reproductive health, its presence does not act as a form of birth control or consistently prevent conception.
BV’s Impact on Conception
The vaginal environment becomes less acidic during BV, with the pH rising above 4.5. This shift, caused by the decrease in protective Lactobacilli bacteria, creates a less favorable environment for sperm survival. The imbalance introduces toxins, such as lipopolysaccharide and vaginolysin, produced by the overgrowing bacteria. These toxins can impair sperm function, reducing motility and the ability to fertilize an egg.
BV is more prevalent in women who experience infertility. The inflammation caused by the bacterial overgrowth can interfere with cervical mucus during ovulation, which is critical for sperm transport. BV also increases the risk of developing Pelvic Inflammatory Disease (PID) if the infection travels up the reproductive tract. Untreated PID can lead to scarring and blockages in the fallopian tubes, preventing the sperm and egg from meeting.
Despite these challenges, BV mechanisms do not consistently stop conception. The condition does not create a permanent block to fertilization or implantation. Although some research suggests a delay in conception may occur, overall fertility is generally maintained. Relying on BV to prevent pregnancy is medically inaccurate.
Potential Risks During Pregnancy
Untreated BV during pregnancy is associated with several serious complications for both the mother and the fetus. The bacteria can ascend from the vagina into the upper reproductive tract, reaching the uterus and the amniotic sac. This ascending infection triggers inflammation that negatively affects the pregnancy environment.
A primary risk is an increased chance of premature rupture of membranes (PROM), where the amniotic sac breaks before labor begins. This complication increases the risk of preterm birth, defined as delivery before 37 weeks of gestation. Preterm delivery is directly linked to a higher incidence of low birth weight (LBW), defined as a baby weighing less than 2,500 grams at birth.
Babies born too early or too small face greater health challenges and require specialized neonatal care. The mother also faces an elevated risk of postpartum complications, such as postpartum endometritis, an infection of the uterine lining after delivery. Screening and treating BV during pregnancy is important for mitigating these outcomes and protecting the health of both mother and child.
Diagnosis and Safe Treatment Options
A healthcare provider typically diagnoses BV by evaluating symptoms, conducting a pelvic exam, and performing laboratory tests. Diagnosis relies on Amsel’s criteria, which includes:
- A thin, grayish-white discharge.
- A vaginal pH greater than 4.5.
- A distinct “fishy” odor when a potassium hydroxide solution is added to a sample.
- The presence of “clue cells” on a microscopic slide, which are vaginal cells coated with the overgrowing bacteria.
Treatment is strongly recommended for all symptomatic pregnant women to reduce the risk of adverse pregnancy outcomes. The standard and safe treatment involves prescription antibiotics, typically oral metronidazole or clindamycin. Metronidazole is often prescribed in a 250 mg dose three times daily for seven days, or a twice-daily 500 mg dose.
Oral metronidazole poses a low risk during pregnancy, as studies show no evidence of teratogenicity or mutagenic effects on the fetus. Clindamycin is also a safe and effective oral or vaginal option for pregnant patients. Adherence to the full antibiotic course is essential to clear the infection and manage associated pregnancy risks.