Chlamydia, caused by the intracellular bacterium Chlamydia Trachomatis, is one of the most common sexually transmitted infections.
If left untreated, in 40% of cases the infection ascends from the cervix to the ovaries, fallopian tubes, or uterus, causing pelvic inflammatory disease (PID) and even infertility.
Fortunately, chlamydia is easily cured with antibiotics such as azithromycin (1 g PO single dose) or doxycycline (100 mg PO every 12 h for 7 days).
When the fallopian tubes are damaged, in vitro fertilization (IVF) is often the best alternative to achieve pregnancy.
What is chlamydia and how does it affect fertility?
It is a silent infection caused by Chlamydia Trachomatis. According to the CDC, 2.8 million people contract it each year in the U.S. In women, 40% of untreated cases progress to PID, damaging ovaries, tubes, and endometrium, which hinders implantation and can lead to infertility.
- Cervical obstruction preventing sperm from passing.
- Altered ovulation and reduced oocyte quality.
- Formation of hydrosalpinx, blocking the tubes and increasing the risk of ectopic pregnancy.
- Endometrial inflammation (endometritis), causing poor implantation.
- Pelvic adhesions that impede gamete transport.
- Pain during intercourse, reducing activity in the fertile window.
What are the main symptoms?
In women, 75% of infections are asymptomatic. When they appear (1–3 weeks after exposure), they may include:
- Abnormal vaginal discharge
- Genital irritation or itching
- Burning during urination (dysuria)
- Bleeding between periods
- Pain during intercourse (dyspareunia)
- Pelvic pain
- Fever
- Difficulty conceiving
If you notice any of these signs, refrain from intercourse and consult a specialist. Timely diagnosis and treatment prevent fertility damage.
How is it transmitted and who is at risk?
It spreads through unprotected vaginal, anal, or oral sex. Risk increases with the number of partners. It can also be passed from mother to baby during childbirth if untreated.
How is it correctly diagnosed?
Diagnosis includes medical history, vaginal examination, and endocervical swab for C. Trachomatis DNA PCR. You can also use a urine test or serology. The CDC recommends annual testing for sexually active women under 25 and for anyone with new or multiple partners.
Always rule out gonorrhea due to possible coinfection and, if tubal damage is suspected, schedule a transvaginal ultrasound.
Treatments and options for seeking pregnancy after chlamydia
- Azithromycin 1 g PO single dose
- Doxycycline 100 mg PO every 12 h for 7 days
Do not self-medicate. Avoid sex until 7 days after completing therapy and ensure your partner is treated too. Perform a follow-up test 3 weeks after treatment.
If tubal damage prevents natural conception, IVF bypasses damaged tubes, retrieves eggs directly, fertilizes them in the lab, and transfers embryos with high implantation rates.
Frequently Asked Questions
Does it always cause symptoms?
No. 75% of women and 50% of men are asymptomatic. It is often detected during STI screenings or when investigating fertility issues. That’s why annual testing is recommended for young women.
Can infertility from chronic chlamydia be cured?
It depends on the damage. If tubes are blocked or there are severe adhesions, natural pregnancy is difficult. IVF is the most effective alternative. In mild damage, surgical repair or prolonged antibiotics may help.
Can I get pregnant after treatment?
Yes, once bacterial eradication is confirmed (post-treatment test 3–4 weeks later). Continue follow-up with a reproductive specialist if you have had PID or difficulty conceiving.
How to prevent reinfection?
Use condoms every time, limit the number of partners, and get regular tests. Both partners should be treated simultaneously and wait at least 7 days after medication before resuming sex.
Sources
- Centers for Disease Control and Prevention. (2023). Sexually Transmitted Disease Surveillance. https://doi.org/10.15620/cdc.sti.2023
- World Health Organization. (2022). Chlamydia. https://www.who.int/news-room/fact-sheets/detail/chlamydia
- Haggerty, C. L. et al. (2010). Risk of sequelae after Chlamydia trachomatis genital infection in women. Journal of Infectious Diseases, 201(Suppl 2), S134–S155. https://doi.org/10.1086/652395
- MedlinePlus. (2023). Chlamydia Infections. https://medlineplus.gov/chlamydiainfections.html
We know this journey can be tough. You are not alone. If you have questions or need a personalized plan, consult an assisted reproduction specialist: together we’ll find the best path for your family.