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{In no situation do we ever recommend that fertility diagnosis or treatment be undertaken without the oversight of a qualified medical practitioner. Please use the enclosed information as quick reference and for discussion aids with your practitioner.}

Sexually transmitted infections (STIs, also called STDs and venereal disease) are any infection that is transmitted from person to person through intimate contact. STIs can also be shared between people who are not sexually involved, whenever a certain amount of bodily fluids (blood, semen, cervical fluid, etc.) are exchanged. Common STIs include:

• chlamydia
• gonorrhea
• syphillis
• human immunodeficiency virus (HIV)
• human papilloma virus (HPV), also called genital warts
• herpes simplex virus (genital herpes)
• hepatitis C & B
• trichomoniasis
• scabies, pubic lice

Myths About STIs

• they happen to "other" people
• you can tell if someone has an STI
• you can tell if you have an STI
• getting an STI is no big deal - it's easy to treat and then you're immune
• if you're clean, well-dressed & groomed, you won't catch them
• if you live in certain areas, you're immune from them
• you must have sexual intercourse to catch them

STI Facts

• The fastest growing population with new cases of STIs are high schoolers. Females are more susceptible to acquiring STIs than males because their anatomy is more prone to infection in general.
  
  
• In most women (and some men), there are often virtually no symptoms of STI. Not only can a partner not tell if a woman has an STI, the woman herself usually does not know.
  
  
• If discovered early enough, treatment can be as simple as antibiotics. However, if a case goes untreated, the damage an STI can do may be permanent, life-altering, or life-threatening. Immunity to STIs does not develop, and some STIs are incurable.
  
  
• STIs have nothing to do with cleanliness or grooming. STIs know no geographical or socioeconomic boundaries.
  
  
• STIs can be transmitted through oral sex, vaginal sex, anal sex, even heavy petting. Penile penetration is not a prerequisite for transmission.

Symptoms

When symptoms are present, it can sometimes mean (for women especially) that infection is advanced. Below are some signs of STI infection:

• Unusual vaginal discharge (changes in color, consistency, amount, odor)
• Penile discharge
• Bleeding after intercourse
• Pelvic pain (pain below the belly button)
• Swollen and/or painful testicles
• Itching or tingling in the genital area
• Blisters or sores on the genitals, anus, or surrounding areas
• Warts or bumps on the genitals, anus, or surrounding areas
• Persistent vaginal yeast infections
• Yellowing of the eyes and skin (jaundice)

(Note: some of these may be symptoms of other health conditions, and should be attended to regardless of sexual activity.)

Link to Infertility

Because males infected with STIs usually seek treatment in order to stop painful symptoms, their incidence of STI-related infertility is less than for women. However, men are not "off the hook" here: approximately half a million yearly develop epididymitis (inflammation of the testicular tubes) from an STI, which can result in decreased fertility or sterility.

Females more typically are not aware of the existence of their STI, therefore do not receive prompt treatment. This often results in pelvic inflammatory disease (PID), a leading cause of tubal-factor infertility, which is one of the most common types of infertility.

Tubal-factor infertility refers to any dysfunction of the fallopian tubes, such as adhesions, scar tissue, or any other blockage of the tubes. Such blockage makes it impossible for the sperm and egg to meet in a natural, unassisted manner. In-vitro fertilization (IVF) was first invented specifically as a treatment for tubal-factor infertility. While it can be successful, IVF to treat infertility is very costly, both financially and emotionally.

Risky Business

Below is a very candid list of behaviors in order of STI transmission risk from highest to lowest risk:

• Unprotected anal intercourse
• Unprotected vaginal intercourse
• Sharing needles (for drugs, piercing)
• Sharing implements that draw blood (whips, knives)
• Unprotected oral sex on a menstruating woman
• Unprotected oral sex on a man with ejaculation
• Unprotected oral-anal contact
• Getting urine or feces in mouth, vagina, anus
• Unprotected fisting or finger insertion
• Unprotected oral sex on a man without ejaculation
• Unprotected oral sex on a non-menstruating woman
• Sharing uncovered sex toys
• Anal intercourse with a condom
• Vaginal intercourse with a condom
• Oral sex on a man using a condom
• Oral sex on a woman using a latex barrier
• Oral-anal contact using a latex barrier
• Fisting or finger insertion using a glove
• Petting, manual-genital contact
• Deep (French) kissing
• Spanking, whipping that does not break the skin
• Bondage and discipline play
• Masturbation (alone or with partner)
• Hugging, touching
• Massage
• Talking dirty, phone or net sex, fantasy

Prevention Measures

The best way to protect future fertility is by avoiding STIs altogether.

In order of prevention success rate:

• abstinence from sexual contact
• using latex or female condoms with spermicidal jelly
• using latex or female condoms without spermicide

In addition to the above:

• Ask your physician for an STI screen regularly if you are sexually active at all. Make it a regular part of your annual gynecological visit or physical.
  
  
• Talk to your sexual partners before engaging in any risky behaviors about the possibilities for both of you. Remember that, in effect, you engage in sexual activity with all of your partner's previous partners.
• Be open with your partners about your own sexual health history.
• Consider avoiding risky contact with any partner who refuses to be open about their health history.

Also see:

• Female Anatomy for Conception
• Male Anatomy for Conception