On the journey to motherhood or fatherhood, every step matters. Every hope, every dream, and every challenge brings us closer to the moment when our desire to conceive becomes reality. But sometimes unexpected obstacles arise, such as chlamydia, a silent infection that can affect our fertility. It is essential to understand how chlamydia can interfere with our plans and how we can face it with courage. Chlamydia, often surrounded by stigma and shame, can make conception difficult. However, let’s focus on our strengths and take charge of our sexual and reproductive health. Below we will see how we can protect ourselves, diagnose, and treat this infection to pave the way toward our longed-for goal: starting a family. What is chlamydia and how does it affect fertility? Chlamydia is one of the most common sexually transmitted infections (STIs) and often goes unnoticed. Caused by the intracellular bacterium Chlamydia trachomatis, it is three times more frequent in women than in men. According to the Centers for Disease Control and Prevention (CDC), around 2.8 million cases are reported each year in the U.S. In 40% of untreated cases, the infection rises from the cervical canal to the ovaries, fallopian tubes, or uterus, causing pelvic inflammatory disease (PID) or tubal blockage. It can impede fertility in several ways: Cervical infection: hinders sperm passage. Ovarian infection: alters ovulation, reduces ovarian reserve, or forms abscesses. Fallopian tube infection: causes hydrosalpinx (fluid accumulation) and increases the risk of ectopic pregnancy. Endometritis: inflames the endometrium and hinders embryo implantation. Inflammatory adhesions: obstruct the transport of oocytes and sperm. Pain during intercourse: may lead to avoiding sex on the days of highest fertility. During pregnancy, untreated chlamydia can cause: Ectopic pregnancy Spontaneous abortion Amniotic fluid infection Premature membrane rupture Preterm birth Low birth weight Neonatal pneumonia or conjunctivitis Main symptoms of chlamydia Chlamydia is often “silent”: up to 75% of infected women show no symptoms. When they appear (1–3 weeks after exposure), they may include: Abnormal vaginal discharge Burning or discomfort when urinating Bleeding between periods Pain during intercourse (dyspareunia) Pelvic pain or fever Infertility If you notice any of these signs, avoid intercourse and see a doctor as soon as possible. Early diagnosis prevents PID and greater damage to your fertility. How is chlamydia diagnosed? Diagnosis includes reviewing medical history, a brief pelvic exam, and collecting a cervical or vaginal sample for nucleic acid amplification testing (NAAT). Urine or blood tests can also detect antibodies. The CDC recommends annual chlamydia screening for sexually active individuals under 25 and for older women with risk factors. Pregnant women should be tested routinely. Since chlamydia and gonorrhea often coexist, it is advisable to test for both. In advanced cases, a transvaginal ultrasound may be necessary to assess pelvic damage. If I test positive and want to conceive, what should I do? If you test positive, abstain from intercourse until you and your partner(s) complete treatment and receive negative follow-up tests. Reinfection is common if only one person is treated. If there is tubal damage, in vitro fertilization (IVF) is the best option, as it bypasses damaged tubes. It is vital to treat the infection before starting an IVF cycle to improve success rates. Do not self-medicate; before taking any drugs, consult a reproductive specialist for proper guidance. Treatment options First-line treatment is azithromycin 1 g in a single dose or doxycycline 100 mg every 12 h for 7 days. Sexual partners must be treated simultaneously to avoid reinfection. Follow-up testing at 3 months is recommended to confirm eradication. If PID has developed, hospitalization and intravenous antibiotics may be necessary. After treatment, a fertility evaluation will guide next steps. How to prevent future infections Always use condoms, limit the number of partners, get regular tests, and maintain open communication with your partner. Routine gynecological visits help detect and treat infections early. Related resources More information at Positive Chlamydia: Symptoms, Causes and Diagnosis. Frequently asked questions 1. Can chlamydia clear up on its own? Some mild cases may resolve without treatment, but relying on this is risky. Without antibiotics, the infection can ascend, cause PID, damage the tubes, and increase the risk of infertility and transmission to your partner or baby. Treatment is the only safe way to eradicate it. 2. How long should I wait after treatment before trying to conceive? After completing medication, wait at least 7 days before resuming sexual activity. A test of cure is recommended at 3 months or sooner if symptoms recur. For IVF, confirm eradication before the cycle; your specialist will advise based on your reproductive health. 3. Does chlamydia affect ovarian reserve? Inflammation from chlamydia can reduce ovarian reserve or disrupt ovulation. While the direct link needs more study, you can assess your reserve with antimüllerian hormone (AMH) testing and antral follicle count via ultrasound. Speak to your reproductive endocrinologist if you have a history of chlamydia. 4. Is it safe to undergo IVF after a chlamydia infection? Yes, IVF is safe and recommended if there is tubal damage. Treating the infection beforehand protects the uterus and improves implantation. Your specialist may perform imaging studies and possibly give antibiotics around the transfer to minimize risks. References Centers for Disease Control and Prevention. (2023). Sexually Transmitted Disease Surveillance. https://www.cdc.gov/std/statistics/2023/default.htm Workowski, K. A., & Bolan, G. A. (2015). Sexually Transmitted Diseases Treatment Guidelines, 2015. Clinical Infectious Diseases, 61(8), e1–e42. https://doi.org/10.1093/cid/civ784 MedlinePlus. (2023). Chlamydia. https://medlineplus.gov/chlamydia.html World Health Organization. (2016). Global health sector strategy on sexually transmitted infections 2016–2021. https://www.who.int/reproductivehealth/publications/rtis/ghss-stis/en/ We are with you on this journey: having children is a deep and achievable desire. Do not hesitate to seek help from a fertilization specialist for the support and guidance you deserve.