STIs and male fertility – is there a link? 

There is a lot of conversation about sexual health and female fertility – but what about STIs and male fertility? Here we’ll discuss some of the most common sexually transmitted infections and how they can impact your sperm health and future fertility. 

Can STIs impact male fertility?

Put simply – yes they can, especially if you leave them untreated. There’s a belief that STIs are more likely to cause infertility in women – and that’s kind of true – but not for the reason, you may think. STIs in men are more likely to show symptoms that are hard to ignore, which means they generally get treated faster before they can do much damage. For women, many STIs are pretty much symptomless, which means without regular sexual health check-ups, they can go undiagnosed and untreated for years. 

The truth is that STIs can cause mayhem for your fertility whether you get symptoms or not, so the best course of action is to use protection and get regular check-ups. Now let’s dive into the most common STIs – protection at the ready! 

Chlamydia

Chlamydia is probably the most common STI of them all – affecting millions of people a year. For women, an untreated case of chlamydia can lead to pelvic inflammatory disease which can have a real impact on fertility – but men aren’t off the hook either! 

Études have indicated that men with chlamydia are at higher risk of DNA Fragmentation. Fragmentation in chlamydia-positive or mycoplasma-positive men was 3.2 times higher than in those who hadn’t come into contact with the virus. 

Now, this doesn’t mean that if you have or have had chlamydia, that your fertility is guaranteed to be impacted – it’s all about catching it early. Men are more likely than women to exhibit symptoms of the infection and they will usually develop around 1-3 weeks after contact with the infection. Keep an eye out for pain when peeing, pain in your testicles or white, cloudy or watery discharge from the tip of your penis. However, only half of men will show symptoms – so staying on top of your sexual health MOT is key! 

Herpes

Herpes is one STI that’s very common and very hard to shift – and yet there is still a big research gap around the impact that this particular STI can have on male fertility. A small scale study found that men with HSV-1 (oral herpes) and HSV-2 (genital herpes) seemed to display a lowered sperm count, but more research definitely needs to be done. 

Unlike conditions like chlamydia – which can be cleared up with a short course of antibiotics – once you contract herpes it stays in your system. However, there are medications that can help to manage the virus –  reducing breakouts and the risk of transmission. This is important because whilst we are still unsure about the link between herpes and male infertility – we do know that it can be extremely harmful to newborn babies. If a woman is infected with herpes during pregnancy, it can pass on to the baby during labour – and in some cases can be fatal. 

If you have the herpes virus and are trying for a baby, you want to be very careful not to pass it on to your female partner. Speak to your GP about the best way to reduce transmission and risk. 

Gonorrhoea

Gonorrhoea can be a really sneaky STI to catch – as symptoms often don’t turn up until a month later! If and when they do show themselves, they can be pretty nasty – keep an eye out for yellow or green discharge from your penis, burning sensation when you pee and a swollen foreskin (ouch…)

When it comes to sperm health, there aren’t masses of research to imply that this STI has a massive impact on male fertility. However, it can cause certain conditions that are linked to infertility – namely urethritis. Urethritis is basically inflammation of the urethra, the tube semen from the testicles and urine from the bladder (the likely culprit of that burning pain when you go to the toilet!) This can also trigger epididymo-orchitis, inflammation of the epididymis (a duct behind the testicles) and/or your testicles themselves. 

With all this potential inflammation going on in your babymaking zone, it’s unsurprising that there could be knock-on effect on your fertility, Whilst a lot more research needs to be done, a small study does indicate a link between gonorrhoea induced urethritis and epididymo-orchitis poor sperm health. In the study, previously fertile men were tested 2 years after having the infection and associated inflammation. Only 40% of the participants had sperm that would be classed as healthy. 

HIV

Years ago, a HIV diagnosis meant that you would struggle to survive – let alone become a father, but luckily nowadays that is far from the truth. With medical advancements, it is now possible to live a happy, healthy life with HIV – and that can also mean starting a family. 

A concern for some people with HIV is it being transmitted during unprotected sex. Whilst with medications like PrEP, the risk of transmissions is lowered to practically zero, if you have a female partner you may be worried about passing on the infection whilst trying to conceive. 

If this is the case, assisted fertility treatments can help you on your road to parenthood! Semen washing can remove sperm from the seminal fluid (the HIV virus is in the fluid, rather than the sperm cells themselves) and then use the sperm in IVF or IUI. One research project showed that across over 10,000 washed semen IVF cycles involving a male partner with HIV, there were absolutely no transmissions of the virus! 

In terms of male fertility and HIV – there are some things to be aware of. Firstly, whilst most medical research indicates that HIV itself does not cause infertility, there is evidence to suggest that the treatment of HIV could. Researchers have found that men with medication-managed HIV have reduced counts, motility and volume. Obviously, your health is paramount, so definitely don’t refuse treatment to prioritise your sperm health! However, it may be worth keeping a check on how your swimmers are doing – or maybe even freezing sperm before starting treatment. 

How to protect yourselves from STIs

As with all things family planning – forward thinking and being proactive is key – which is why it’s important to look after your sexual health ahead of becoming a father – and that means using protection. Now, it might seem counterproductive for a fertility business to tell you to use condoms, but as the above research shows, there is a definite link between STIs and male fertility. If you’re not actively trying for children right now, condoms are the best way to protect you from sexually transmitted infections, as well as pregnancy. 

The other key thing is to get tested regularly – especially if you have multiple sexual partners. It can be daunting to get checked out, but if you have anything it means you can get treated right away – which is also important. The vast majority of STIs won’t impact male fertility if you catch and treat them early and will often be cleared up with a course of antibiotics. 

The vast majority of STIs won’t impact male fertility if you catch and treat them early and will often be cleared up with a course of antibiotics. Call your doctor as soon as you have a suspicion that you have been contaminated or if you have any symptoms of infection. It’s better to call one time too many than to regret it later!”

Dr Fatin Willendrup, responsable des affaires médicales chez ExSeed Health

How to stay on top of your fertility 

If you’re reading this and are concerned that a previous STI could have impacted your fertility – don’t stress. Just like it’s easy to check up on your sexual health, you can also check out your sperm health swiftly and simply. Our at-home sperm tests mean you can get to know your swimmers and check if your motility and count are normal – all from the comfort of your own home.