Sharon Perkins - Getting Pregnant For Dummies

Most of the time, CMV is inactive (dormant), but it can activate at any time. When the infection activates, it can be spread to other people and babies. Healthy people rarely experience significant problems from CMV, although it can cause mononucleosis. Adults with a compromised immune system are more susceptible to infections that affect the eye, digestive system, and nervous system, and it can cause pneumonia. Infants can be born with congenital CMV, but this is more likely to happen if the mother contracts CMV for the first time when she is pregnant and not from reactivated CMV. Congenital CMV may cause the baby to have loss of vision, neurological problems, hearing loss, seizures, muscle problems and loss of coordination, and impaired intellect. The most common problem for infants with congenital CMV is hearing loss.

There is no cure for CMV, and healthy people generally do not need treatment. However, antiviral medications may be given to babies and people with weakened immune systems.

CMV does not appear to have an impact on fertility, but if it is an active infection, CMV can cause problems in a developing fetus leading to low birth weight, blindness, deafness, mental retardation, small head size, seizures, or damage to the liver or spleen. Testing “positive” for CMV means that you have been infected sometime in your lifetime, but there’s no way of knowing when. If your infection is not active, the risks in pregnancy are reduced.

If you are CMV negative and are considering using donor sperm, you may want to know if the donor is CMV negative. That way you will not have to worry about getting CMV yourself or it being a factor in any potential pregnancy.

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae, which can infect the genital tract, mouth, or rectum. Infants can get the disease from an infected mother during childbirth. It can be carried by males and females and can be cured with antibiotics. Here are some other facts about gonorrhea:

Each year, 820,000 new cases of gonorrhea are diagnosed.

Gonorrhea is the second most reported STI.

Gonorrhea can lead to infertility. Like chlamydia, gonorrhea in women can cause PID, leading to tubal damage. Some doctors test for gonorrhea and chlamydia before doing common fertility tests such as a hysterosalpingogram (HSG), in which dye is injected into the uterus and fallopian tubes to see whether there are any irregularities. (We discuss HSGs in more detail in Chapter 11.) If you have gonorrhea or chlamydia and push dye into the tubes and uterus, you may push the infection up also and end up with more tube or uterine damage than you had to begin with.

Men with gonorrhea usually have a discharge from the penis and a burning sensation; women may have no symptoms or sometimes pain on urination or an increased vaginal discharge.

Gonorrhea is diagnosed by testing the urine or by taking swabs of the cervix, mouth, or anus. Treatment for uncomplicated gonorrhea involves intramuscular injections of antibiotics (shots!). Lately, drug-resistant forms of gonorrhea have emerged, which makes treatment more difficult, so antibiotic injections are now combined with oral antibiotics when these strains are found.

Syphilis is caused by the bacterium Treponema pallidum. The bacterium can be transmitted through genital, oral, or anal contact. The good news is that syphilis is easily cured with penicillin. The bad news is that this infection is on the rise.

The number of reported syphilis cases rose over 70 percent from 2013 to 2017.

Men, especially men who have sex with other men, are affected the most.

Over 100,000 cases of syphilis were reported in 2017, with a rise in syphilis in heterosexual men and women.

Syphilis can cause epididymitis in men and can be passed to an unborn child during pregnancy or at birth.

Syphilis frequently starts as a painless sore on such areas as the mouth, genitals, or rectum. The sore is called a chancre, and this stage of syphilis is called primary syphilis. The sore may never be noticed and heals without intervention in 3–6 weeks. The next stage of syphilis is called secondary syphilis and is hallmarked by a rash that is frequently painless but can occupy the entire body including the palms of the hands and soles of the feet. This may continue for up to a year. The third stage of syphilis is called tertiary, and 15–30 percent of people infected with syphilis reach tertiary syphilis without treatment. Tertiary syphilis can lead to life-threatening problems with almost every system in the body and may not appear until years after the initial infection. Syphilis was a major cause of death until penicillin was available after World War II. In fact, it’s hit some pretty well-known people. Al Capone had tertiary syphilis, which destroyed his brain while he was incarcerated at Alcatraz. Capone was one of the first people to get penicillin, but it was too late. He eventually died at age 48 of heart disease believed to be related to his syphilis infection.

Babies born with syphilis contract the disease through the placenta or during birth. Usually the baby is initially without symptoms but eventually may develop deafness, teeth deformities, or saddle nose (loss of height of the nose.) Syphilis is diagnosed with blood or spinal fluid tests. The initial test is a screening test that does not miss many people who are infected. However, the screening test tells a number of people they do have syphilis when in fact they don’t. So, if the first test is positive, a second test is done which accurately identifies the people who truly are infected.

Syphilis is easily treated if diagnosed early. A single injection of penicillin can cure syphilis if diagnosed within a year of exposure, but after that a more extensive treatment with penicillin is needed. Other antibiotics may be used. Contrary to folklore, syphilis can’t be caught from a toilet seat.

Early detection of syphilis is key, and it can be easily treated with penicillin (or another antibiotic if you are allergic to penicillin). Don’t be afraid, embarrassed, or otherwise deterred from talking to your doctor about STIs. Ignoring syphilis can be devastating to you, your partner, and your child.

Genital herpes is caused by the herpes simplex type 2 virus (HSV). The cold sores some people are prone to on their lips are caused by the herpes simplex type 1 virus (although you can get genital herpes with type 1 and cold sores with type 2 — STIs don’t always play by the rules!). Currently, there is no vaccine against genital herpes in the works, but a few scientists are working on one for oral herpes. In the meantime, caution should be exercised when having a sexual relationship with an infected person as it is spread through body fluids. Here’s some other information on herpes:

Fifty percent of Americans under age 50 are infected with oral herpes.

One in eight people in the United States have genital herpes, with 500,000 new cases diagnosed each year.

Unlike some of the other STIs, the incidence of genital herpes is decreasing.

Once you are infected with the genital herpes virus, it stays in your body forever, even though initial symptoms of flu-like symptoms and chancres may disappear within two to three weeks. Occasional flare-ups can be managed with antiviral medications like acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex).