Key Takeaways
- Pelvic inflammatory disease (PID) can block the fallopian tubes, affecting female fertility in return.
- STIs like gonorrhoea and chlamydia are the leading cause of PID.
- Early diagnosis and treatment of STIs greatly reduce the risk of PID complications.
- PID is curable. Early treatment can significantly reduce the risk of infertility.
- Infertility treatments like IUI and IVF are often recommended for women experiencing conception challenges due to past history of PID.
Starting a family can be an exciting milestone, dreamed by a great many couples. But when fertility issues arise, they’re often left feeling confused and concerned, wondering why conceiving seems so difficult.
This can be particularly true for women with a history of Pelvic Inflammatory Disease (PID). PID is a common reproductive issue, often caused by untreated sexually transmitted infections (STIs), and it can have a lasting impact on fertility.
Here, we’ll explore how PID affects a woman’s chances of getting pregnant, and discuss steps to support her reproductive health—whether she’s trying to conceive naturally or through assisted options like IUI or IVF.
What is Pelvic Inflammatory Disease (PID)?
Pelvic Inflammatory Disease (PID) is a bacterial infection that affects the upper female reproductive organs, including the cervix, uterus, fallopian tubes, and ovaries. This disease is often caused by untreated sexually transmitted infections (STIs) like gonorrhoea and chlamydia, though other infections can also be responsible for it.
As the name suggests, PID causes inflammation and swelling in the affected organs. When these reproductive organs become inflamed or swollen, their ability to function properly, especially in terms of fertility, becomes disrupted.
Unfortunately, many cases of PID are only diagnosed in later stages. Many women with this condition show little to no symptoms, and even when symptoms do appear, they can vary significantly and are often mistaken for other types of infections.
PID Risk Factors
Pelvic Inflammatory Disease (PID) is a secondary infection, typically developing after a primary infection. Your risk of having PID increases with the following factors:
Having Untreated STIs
Untreated STIs such as gonorrhoea and chlamydia can lead to PID if left untreated. The bacteria Neisseria gonorrhoeae or Chlamydia trachomatis, initially infecting the cervix, can travel to the upper reproductive organs, spreading to the uterus, fallopian tubes, and ovaries.
These infections often show mild symptoms, or are even asymptomatic, making them easy to overlook. Unfortunately, complications like PID often arise from silent infections like these that go undiagnosed and left untreated.
Non-STI Bacteria
While STIs are the most common cause of PID, other infections that affect the genital area can also lead to this condition. These can include bacterial vaginosis (BV), Bartholin gland abscess, and postpartum infections to name a few.
In such cases, bacteria can ascend through the cervix and spread to the uterus, fallopian tubes, and ovaries, similar to how STIs spread. This can result in the development of PID, which may lead to long-term complications.
Intrauterine Device (IUD) Contraceptive
Although rare, there are cases where PID can develop following the use of an IUD. This typically occurs when the cervix’s natural barrier is temporarily disrupted during insertion, allowing bacteria to enter the upper reproductive tract.
Additionally, if an undiagnosed STI such as gonorrhoea or chlamydia is present at the time of insertion, the procedure may facilitate the spread of the infection to the uterus and fallopian tubes, increasing the risk of PID.
Appendicitis
An untreated appendicitis, or a painful swelling and inflammation of the appendix, can lead to serious complications, including PID. If the appendix ruptures, bacteria can spread into the pelvic cavity and reach the upper reproductive tract, potentially causing infection.
While such cases are rare, they can be severe. A ruptured appendix is already a medical emergency on its own, and when complicated by PID, the risks become even more concerning.
Douching
Though douching doesn’t directly cause PID, it can disrupt the vaginal balance. This disruption can trigger infections like bacterial vaginosis (BV) and candidiasis (yeast infection), and may make sexually active individuals more susceptible to STIs—which are the leading causes of PID.
What are Symptoms of PID?
In its early stages, symptoms of PID are usually mild and can be easily overlooked. Individuals with this disease may experience one or more of the following signs, but nor necessarily all of them:
- Pelvic pain: Pain around the lower tummy is the most common symptom of PID. Each woman may experience it differently, ranging from mild to severe painful sensation.
- Painful sexual intercourse: With PID, sexual intercourse can be painful, and bleeding during or after sex can occur too.
- Painful urination: PID can cause inflammation and irritation around the urethra and bladder, which can lead to painful sensation when peeing.
- Irregular period: Women affected by PID may experience irregular menstrual cycles, including heavier-than-usual bleeding, spotting between periods, or unusually painful periods.
- Abnormal vaginal discharge: Usual vaginal discharge is another sign of PID to look out for. The discharge is often thick, green or yellow in colour, and has a foul odour.
If you have risk factors for PID and consistently experience any of the symptoms mentioned above, getting tested would be beneficial. PID is treatable, and early medical intervention can prevent it from progressing into more serious complications.
How to Prevent PID?
Since PID is a secondary infection, it goes without saying that preventing or treating the initial infection is how you stay protected from it. Depending on individual circumstances, PID prevention strategies can vary, including:
- Safe sex practises: Consistent and correct use of condom can reduce the risk of STIs, particularly for individuals with multiple sexual partners.
- Regular STI testing: Regular STI testing allows for early prevention should any infection is detected, preventing it from progressing into complications like PID.
- Prompt treatment of detected infections: Whether STI-related or not, treating infections early can prevent them from spreading to the upper reproductive tract and causing PID.
- Avoid douching: Unless recommended by your doctor, douching should be avoided, as the vaginal imbalance it causes can make you more susceptible to STIs and other vaginal infections.
- Proper hygiene and care: Make sure to follow doctor’s hygiene recommendations after procedures like IUD insertion, childbirth, or miscarriage, which helps to prevent bacterial infection that may lead to PID.
How does a History of PID Affect Fertility?
A history of PID can negatively affect fertility, due to the damage it causes to the upper reproductive tract. The more severe or frequent the infections, the more challenging it may be to conceive.
Here are examples of fertility issues that can be linked to PID:
- Tubal factor infertility: It’s a kind of female infertility caused by blocked fallopian tubes. PID can be responsible for it, as this disease can inflame or scar the surrounding tissue, which prevents the egg and sperm from meeting.
- Ectopic pregnancy: The scarring that PID causes to the fallopian tube may lead to what’s called tubal adhesion—where a fertilised egg is unable to travel to the uterine cavity, leading to an ectopic pregnancy that requires medical termination due to its life-threatening nature.
- Endometriosis: While PID doesn’t directly cause endometriosis, research suggests that women with PID or past history of it, are three times more likely to develop endometriosis. Conceiving, in this case, can be challenging due to inflammation, scarring, and distorted pelvic anatomy caused by endometriosis.
While these are common outcomes, every case is unique. Early diagnosis and treatment of PID can greatly reduce the risk of long-term fertility issues.
Can I Get Pregnant with a History of PID?
While conceiving with a past history of PID can be more challenging, it doesn’t mean pregnancy is impossible. Your likelihood of conception largely depends on:
- The severity of PID: The more severe the infection and the greater damage to the fallopian tubes or the surrounding reproductive organs, the more fertility may be affected.
- Frequency of infections: Repeated episodes of PID can increase the risk of scarring, blockage, adhesion, and other kinds of damage to the upper reproductive tract that can make conception more difficult.
- How early it was treated: Early diagnosis and treatment can significantly reduce long-term complications from PID, including infertility.
- Other underlying conditions: Conditions like endometriosis or hormonal imbalances, when present alongside a history of PID, can make conception even more difficult. Addressing these concerns is just as important when planning to get pregnant.
If you’re planning to start a family, yet a history of PID lingers in the back of your mind, seeking guidance from a fertility coach can be beneficial. Based on your fertility assessment results, they can provide you with tailored advice to support you through your parenthood journey—whether naturally or through assisted methods like IUI and IVF.
Does a History of PID Affect IUI and IVF Results?
Assisted reproductive options like IUI and IVF are often recommended for those struggling to conceive naturally, including individuals with fertility issues linked to a history of PID.
Questions are, how effective are these methods? Are they helpful, or could they end up being a costly disappointment?
It’s hard to say for sure, as results from IUI or IVF largely depend on the extent of damage caused by PID. Here’s how each method works, especially in the context of a past PID diagnosis:
- IUI (Intrauterine Insemination)
IUI is performed by placing sperm directly in the uterus, bypassing the cervix. The hope is that the sperm can fertilise eggs in the fallopian tube for a pregnancy to happen.
However, IUI may be less effective if PID has caused significant blockages in the fallopian tubes. Since this method still relies on the egg traveling through the tubes, any scarring or adhesions can reduce the chances of success.
- IVF (In Vitro Fertilisation)
IVF is a more preferred option for those with tubal damage. It’s done by fertilising eggs by sperm outside the body, or in a lab, to further implanted in the uterus.
The success of IVF largely depends on the extent of damage caused by PID. Factors like ovarian reserve, egg quality, and the health of the uterus all play a critical role. If these aren’t significantly affected, IVF may offer a promising path to pregnancy.
Ultimately, results can vary from one individual to another. Consulting a fertility coach can provide you with a realistic expectation and help you decide which option is best, often acquired after you undergo an HSG or a laparoscopy.
Final Thoughts: We’re Here to Support Your Journey to Parenthood
Every path to parenthood is unique, and yours is no exception. While a past history of PID does affect fertility and adds challenges to conception, it doesn’t always mean your dream is out of reach.
A gentle, thoughtful fertility screening is the first step to gain the clarity needed to move forward. This can help you and your partner better understand reproductive health, explore suitable treatment options like IUI or IVF, and take informed steps toward achieving pregnancy.
Our experienced fertility coach is here to guide you with compassion and care. Whatever your next step looks like, we’re here to support your journey to parenthood. Book your appointment today.
FAQs
Can PID make you permanently infertile?
Delaying treatment of PID, to the point that the infection severely damages the reproductive tract can cause permanent infertility. That’s why early intervention is necessary to reduce the risk of infertility.
What damage can PID cause?
PID can damage the upper reproductive tract, but the most affected organ is the fallopian tubes, where they become blocked from the inflammation and scarring PID causes.
Can you fully recover from PID?
Yes, you can fully recover from PID if you get diagnosed and treated early.
Can PID recur? If so, how do I stop it?
Yes, PID can recur. To help prevent this, it’s important to avoid sexual intercourse during treatment until the infection has fully cleared. This reduces the risk of reinfection and supports proper healing.