How STDs can influence your fertility By Marilize Nel Amy* walked into the clinic, clutching her purse close to her slim body. She and her husband are having trouble getting pregnant. After a year of trying without any positive results, she was directed to a private fertility clinic where they could find out why they can’t have a baby.
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Amy is terrified: she led a very risky life when she was a teenager. She fell pregnant after her first sexual encounter. Scared that her parents will find out, 15-yearold Amy got rid of the baby. Deep in despair, she fell for a bad guy who insisted on unprotected sex. Ten years later, Amy had received treatment for Chlamydia, Gonorrhoea and Hepatitis. When a friend took her to church in her late twenties, she immediately decided to follow the faith. She met her current husband in church and they quickly became friends. He is aware of her background and has accepted and forgiven her, but when they struggled to get pregnant, Amy started suspecting that her previous lifestyle may have left some permanent marks on her life. In fact, 25% of infertility cases in South Africa are linked to STDs. Gonorrhoea and Chlamydia are often found together and while Gonorrhoea isn’t very prevalent among the higher classes anymore, girls between 15 to 25 are the most susceptible to these diseases. If left untreated, both of these STDs can lead to Pelvic Inflammatory Disease (PID). PID is an infection which often leads to blocked fallopian tubes. In a woman’s anatomy, the fallopian tube carries the fertile egg from the ovary down the tube where it is fertilized with sperm. Once the embryo is formed, the tube moves it down to the uterus where it is implanted in the wall of the uterus. If the fallopian tube can’t do its work properly, the sperm won’t be able to reach the egg to fertilize it. If it succeeds despite blocked tubes, the embryo could get stuck in the fallopian tube, causing an ectopic pregnancy. An ectopic pregnancy is relatively common, but it is fatal to the fetus www.poznews.net
“because the embryo is implanted in the fallopian tube and usually, the doctors take the fallopian tube out,” says Dr. Wiswedel from the Cape Fertility Clinic. “You cannot re-implant the baby somewhere else.” When PID has caused a blockage in the fallopian tubes, the only viable option to get pregnant is with the help of a fertility specialist. According to Dr. Wiswedel, “tubal surgery has been abandoned largely since about 15 to 20 years because the results are so poor.” The best prognosis for tubal surgery is a 60% chance of success if there was only mild damage. The success of the surgery can only be determined one or two years afterwards and in no way is it guaranteed.
TRADITIONAL MEDICINE
Baby Blues The pregnancy rate of IVF treatments are so good that the tubal surgery isn’t needed anymore. IVF bypasses the fallopian tubes completely by implanting fertilized embryos directly into the uterus. “There is still a danger of having an ectopic pregnancy because the embryo can be flushed into the tubes by the currents inside the uterus,” says Dr. Wiswedel. “As a result, half a percent of IVF pregnancies will turn out as an ectopic.” While IVF is mostly used in cases of blocked tubes, egg donation is also an option. Instead of using her own eggs, the woman will then use a younger donor’s eggs to become pregnant. Most women opt to try with their own eggs first, in a bid to have their own biological children, but the success rate for three IVFs equals the success rate of one egg donation. A woman’s fertility is directly linked to her age and for this reason, a younger woman’s eggs have a higher success rate. The cost of three IVF cycles is considerably more than one egg donor cycle. One IVF cycle is about 25% less than an egg donation procedure, but three IVF cycles are needed to equal the 70% success rate of an egg donation. Simply put, it can cost around R40 000 - R60 000 more to do three IVF cycles than it would cost to do one egg donor cycle, with their success rates being equal. October 2010
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