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Chlamydia, Mycoplasma and Ureaplasma – their impact on female fertility

Nowadays sexually transmitted infections (STIs) are still concern despite the improved level of sexual education and the widely available means of protection. Chlamydia infection remains one of the most common in sexually active people. By contrast, the  bacteria of the genus Mycoplasma and Ureaplasma are found in many women but rarely cause infections.

We can be infected with chlamydia during vaginal, oral and anal intercourse. The infection is also transmitted by an infected mother to her child during childbirth. The biggest problem with chlamydia infection is the lack of symptoms in nearly 80% of women. When symptoms develop, they are non-specific and can be ignored. These include vaginal discharge, burning during urination, and lower abdomen pain.

If left untreated, the chlamydial infection spreads through the cervix, the uterus and the Fallopian tubes. The inflammation caused by the infection can result in outgrowth of connective tissue and blockage of the tube, as well as accumulation of fluid inside it (termed “hydrosalpinx”). Hydrosalpinx could affect one or both tubes.


If one uterine tube is intact, the chances of natural pregnancy are only slightly reduced. If both tubes are affected, however, spermatozoa cannot reach the ovulated egg. In those cases we talk about “tubal infertility”.

This diagnosis is confirmed after salpingography – a method of visualizing the tubes. In case of obstruction of both tubes,  your obstetrician-gynecologist will discuss your options with you. Most commonly patients with tubal infertility who want to conceive are referred for in vitro fertilization (IVF).


Bacteria from the genera Mycoplasma and Ureaplasma are found in many women. They do not cause infections under normal conditions, in other words if your immune system functions normally. Some researchers report, however, that if they get into the uterus, for example through the embryo transfer catheter, they may prevent embryo implantation and pregnancy.

The most sensitive method for discovering these bacteria in women is Polymerase Chain Reaction (PCR) of vaginal secretions, cervical secretions or urine. Women are usually referred for PCR for Mycoplasma/ Ureaplasma if no bacteria commonly causing infections are found or if the antibacterial treatment prescribed is not working.


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