By Dr. Latifa Aboulmajd (Gynaecologist – Reg. No. 03-0311750).
According to the latest report by the Ministerio de Salud and the Instituto de Salus Carlos III on the epidemiological surveillance of sexually transmitted infections (STIs) in Spain, a generalised increase has been observed in all STIs monitored, especially gonorrhoea and Chlamydia trachomatis.
The same report highlights that this increase has been particularly significant in the 15-24 age group.
A total of 88,602 cases of sexually transmitted infections were reported during 2023: gonorrhoea has increased by around 43% between 2021 and 2023, syphilis by 24% and chlamydia has grown by 20.7% annually between 2016 and 2023.
But beyond the general health risks of contracting an STI, how do these diseases affect fertility?

Sexually transmitted infections (STIs) can have a significant impact on a woman's fertility, especially if they are not detected and treated in time. Chlamydia and gonorrhea, for example, can cause pelvic inflammatory disease, which can lead to scarring and adhesions that block the fallopian tubes, preventing the egg and sperm from meeting.
Syphilis, on the other hand, can cause complications during pregnancy, leading to miscarriages or premature births. The Human Papillomavirus (HPV) can cause cellular changes in the cervix that, if left untreated, may develop into cervical cancer.
In men, chlamydia and gonorrhea can cause inflammation of the epididymis (epididymitis) and testicles (orchitis), which can damage tissues and affect sperm production. Additionally, if this inflammation becomes chronic, it can lead to obstruction of the ducts that transport sperm, preventing its proper release.
HPV can cause alterations in semen, affecting sperm quality, while syphilis and genital herpes can lead to inflammation and scarring in the reproductive organs, impacting sperm production and quality.
The best way to protect our health and fertility is to prevent these diseases. The use of condoms and vaccination greatly reduces the risk of contracting STIs, but regular testing is also essential, especially for individuals with multiple sexual partners.

It is also important to avoid risky behaviors, such as sharing needles, which can transmit infections like HIV and hepatitis, and to use appropriate lubricants (water- or silicone-based) to prevent condom breakage during sex. Of course, early detection of these diseases is crucial for protecting fertility in both men and women. Timely treatment can prevent severe complications, improve sperm and egg quality, and reduce the risk of transmitting infections to others.
Assisted reproduction techniques can be highly beneficial for individuals with sexually transmitted infections. In vitro fertilization (IVF), for example, allows for the separation and treatment of gametes (eggs and sperm) in a controlled environment, minimizing the risk of infection transmission. Additionally, Intracytoplasmic Sperm Injection (ICSI), which involves directly injecting a sperm cell into an egg, is particularly useful when sperm quality is compromised due to an STI.
Furthermore, sperm washing is used in cases of infections such as HIV, removing viral particles from the semen before insemination.