CHLAMYDIA AND INFERTILITY (Part 2)

Last week, we started a topic on Chlamydia and its effect on fertility. We discussed the risks, signs, symptoms and complications of chlamydia. This week, we will conclude with its effects, diagnosis, prevention and treatment.

EFFECT OF CHLAMYDIA IN FERTILITY
Chlamydia is a disease that often does not show any symptoms and therefore can go undetected for a long period of time, causing serious harm to the reproductive system in both men and women. Chlamydia infection is very common in young women as there is still very little education about sexually transmitted diseases for teenagers. This lack of education leads to young women getting tested very late, most times after damage to the fallopian tubes. Majority of these women may progress to become infected with what is known as pelvic inflammatory diseases (PID). Some symptoms of PID include:

• Yellow or green vaginal discharge
• Nausea, fever and vomiting
• Pain and tenderness in the lower abdominal region
• Painful or frequent urination.

These symptoms are not mutually exclusive and they will often occur in conjunction with one another. However, of even greater concern is that up to 70% of all women are asymptomatic (no sign), which causes the fallopian tubes to become infected and blocked at the very end – this is known as hydrosalpinx. Some women may also develop scar tissues around the fallopian tubes making it difficult for the tubes to pick up the egg at the time of ovulation. This result in severe difficulty in becoming pregnant, complete infertility and also increases the risk of ectopic (tubal) pregnancy.

In men, chlamydia manifest itself as a urethral infection that may sometimes spread to the testicles, leading to a condition known as epididymitis and if it is not treated promptly, infertility may occur. Chlamydia can also be problematic in men as studies suggest that men diagnosed with chlamydia may have sperm with DNA damage.

DIAGNOSIS OF CHLAMYDIA
The most common test to detect chlamydia infection in women involves taking a swab from the cervix during a speculum examination. The swab of discharge from the cervix (the lower narrow end of the womb) is tested for chlamydia DNA. This test does not indicate how long the infection has been present, how severe the infection is and whether the woman with the infection has sustained tubal damage. The swab test can also miss an infection that has moved up into the uterus or tubes if tested late.

For men, the doctor or physician inserts a slim swab into the end of the penis to get a sample from the urethra. In some cases, the physician will swab the anus. Also, a sample of urine may be collected to be analyzed in the laboratory for the presence of this infection.

PREVENTION OF CHLAMYDIA
• The best way to prevent chlamydia infection is to abstain from sexual activities, and if you must have sex make sure to use a female polyurethane condom or a male latex condom during sexual contact. If condoms are used properly during every sexual encounter, it may reduce infection but cannot eliminate the risk of infection.

• Reduce or limit the numbers of sex partners because having multiple sex partners puts you at a high risk of contracting these and other sexually transmitted infections.
• If you are sexually active with multiple sex partners, you should try to get regular screening for chlamydia and other sexually transmitted diseases.
• Avoid washing or cleaning out the inside of the vagina with soap or other mixtures of fluid because it reduces the numbers of good bacteria present in the vagina thereby leading to a risk of chlamydia and other infections.

TREATMENTS OF CHLAMYDIA
Chlamydia infection can be easily cured and treated with antibiotics. Partners should ensure they get tested. Couples with chlamydia should abstain from sexual activities until completion of a 7-day course of antibiotics to prevent reinfection and further spread of infection to partners as having multiple infections increases a woman’s risk of serious reproductive health complications such as pelvic inflammatory disease, ectopic pregnancy and infertility. It is important to take all the medication prescribed to cure this infection. Medication for chlamydia should not be shared with anyone. It should be known that chlamydia medication can cure infection but will not repair any permanent damage done by the disease. Although, treatment of fallopian tube blockage may be done in two ways – Either the physician may perform a procedure that is minimally invasive to treat the blockage of the fallopian tube or couple may take the option of In-Vitro Fertilization (IVF) treatment when trying to conceive.

CONCLUSION
Chlamydia is a common sexually transmitted bacterial infection. It often produces no symptoms, but screening can show if a person needs treatment. For this reason, treatment and screening are essential for those who may be at risk as highlighted above. If symptoms persist days after receiving treatment, it is advisable to see your clinician /fertility specialist to be reevaluated.