in this issue
Sonja Kristiansen, MD
Medical Director & founder
of
the Houston
Infertility Clinic, Dr. Kristiansen is double board
certified
in
Reproductive
Endocrinology and Obstetrics & Gynecology and
specializes in surgical and IVF procedures.
She has
advanced training in hysteroscopy, laparoscopy, and
microtubal reconstruction. She also works with
female endocrine abnormalities relating to
menstrual and reproductive development.
Quick Links...
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Dear Sonja,
A few weeks ago, news headlines blared the bad
news: one in four American teen girls have a sexually
transmitted disease.
What does this mean to a fertility specialist? What
does it mean to women who want to get pregnant?
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STD 101
A number of sexually transmitted diseases can
silently result in tubal factor infertility, one of the more
common causes of infertility in women. In fact, in vitro
fertilization (IVF) was initially developed to treat tubal
infertility, the result of scar tissue built up to the point
of blocking the ovulated egg's path toward conception.
Bacterial infections like chlamydia and gonorrhea are
common causes of tubal scarring. Syphilis can lead to
very serious health conditions. Fortunately, bacterial
STD's can be cured with relative ease through oral or
injection antibotics. All of them are highly contagious,
spread with relative ease even from physical intimacy
without penetration.
Chlamydia and gonorrhea, particularly, can do a lot of
damage within a woman's body with little or not
noticeable symptoms. The longer a woman has these
diseases, the greater are the chances of her future
fertility being damaged.
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Are You At Risk?
Virtually any women who has had sex is at risk for
exposure to STD's. Even if she's only had one partner
in her life (which isn't a common situation,) chances
are good that her partner has had more than one
partner. Accordingly, women who've had more sexual
partners are at greater risk.
It's relatively common for women to not know they've
had an STD until they have difficulty getting pregnant.
Their concerns are often confirmed with a diagnostic
test known as the hysterosalpingogram (HSG). The
HSG test allows us to view the patency of a woman's
fallopian tubes by observing with ultrasound how well
fluid flows through between the ovaries and the
uterus. Scarring from STD related damage may
partially or totally block fallopian tubes.
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Tips for Reducing Your Risk
Don't assume you're fully informed about someone's
health status by appearance only. Make getting tested
for STD's a regular part of your health care routine,
and expect the same of your sexual partners.
In addition to monogamy, the use of latex condoms
with water-based lubricants is one way to lessen risk
of STD exposure.
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The Fertility Expert's Concern
In addition to the high incidence of STD-related tubal
factor infertility, as a physician, I'm also concerned
about my patients' overall health, the health of their
future pregnancies and children (most STD's can be
passed on to babies in utero or through the birth
process), and the general public's health.
For these reasons, we routinely screen our patients
and their partners for HIV, syphilis, hepatitis,
Chlamydia, and gonorrhea.
Another treatment-related reason for screening
fertility patients: if the patient needs IVF to conceive,
Federal regulations for the protection of human tissue
prevent us from freezing infected samples, a
precaution necessary for the safety of non-infected
sperm or embryos.
Any patients who test positive for STD's will be
required to fully treat the condition before resuming
fertility therapy. The impact on a patient's fertility of
previous infection will vary, and fertility treatment
recommendations will vary accordingly. For some
patients, surgical correction of lesser tubal blockages
may be followed by treatment with intrauterine
insemination (IUI). In general, IVF is a very reliable
workaround for even completely blocked and
damaged fallopian tubes.
In Closing
In this day and age, there's no need for social stigma
to stand in the way of your health or ability to conceive.
STD's are bacterial and viral infections, not indicators
of moral judgement. My staff and I welcome your
questions about all of your fertility and reproductive
health concerns.
Sincerely,
Sonja B. Kristiansen, MD
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