Sharon Perkins - Getting Pregnant For Dummies

There is no clear link between genital herpes and infertility; however, some researchers have suggested that the virus may cause implantation problems in women. The bigger issue is if you become infected late in your pregnancy, or you have an outbreak at delivery. Having genital herpes before a pregnancy has a very low risk of transmitting the infection to your baby.

There is a 30–50 percent risk of infecting a fetus if the mother first contracts genital herpes late in her pregnancy.

If you have an outbreak of genital herpes at the time your baby is ready to be delivered, you’ll need to have a cesarean section; if you deliver vaginally without treatment, your baby may suffer from neonatal herpes (leading to central nervous system damage, mental retardation, or even death).

Antiviral medications are generally safe to take during pregnancy.

Human immunodeficiency virus (HIV) is a chronic infection that may or may not lead to the disease AIDS (acquired immune deficiency syndrome). At present, there is no cure for HIV or AIDS, although antiviral medications may keep HIV under control for some time. There are over one million people in the U.S. living with HIV, and approximately 15 percent of them are undiagnosed. Just under 40,000 new cases are reported per year.

While some HIV-infected men may have sperm abnormalities (like a lower sperm count), many will see no impact on their ability to father a child. Further, special sperm preparation and IUI or IVF with ICSI can significantly reduce the likelihood of transmitting HIV to their partner or fetus. HIV-infected women do not have fertility issues simply due to their HIV. Pregnancy is another story.

Check out the following facts about HIV and pregnancy:

Women with HIV can become pregnant and carry the pregnancy to term, but they risk transmitting HIV to the baby or causing birth defects due to the medications they may be on.

The risk of transmission is about 25 percent if you’re untreated but may be reduced dramatically if you receive antiviral drug regimens while you’re pregnant.

You can reduce the chance of infecting a newborn to approximately 2 percent by using antiretroviral meds and not breastfeeding.

You may reduce the risk of transmission of the disease to your baby if you have a cesarean section rather than a vaginal delivery.

You must wait 3 to 18 months after delivery to find out whether your baby is HIV positive, because during pregnancy your antibodies are passed to the baby. This means that all babies of HIV-infected moms will test positive at birth. It can take as long as 18 months for all your antibodies to disappear from your baby’s blood. After your antibodies are all gone, if the baby tests positive, it means he or she is infected with the virus.

You can be tested for sexually transmitted diseases, including HIV, before trying to conceive. If you are using any third-party reproductive techniques, you will be required to have many of these tests (we talk more about this in Chapter 20). If you suspect that you may have an STD, or have been exposed to one, you need to rule out this potential danger to your fertility and your unborn child.

Trichomoniasis (commonly known as “Trich”) is a sexually transmitted disease cause by the parasite Trichomonas vaginalis. Trich is the most common curable STI, and one estimate reports that 3 percent of all women in the reproductive age are infected. The disease is largely without symptoms in both men and women, with over 80 percent of those infected without symptoms. Symptoms, when they occur, include a vaginal discharge, itching of the perineum, odor, and irritation. There are tests that can be done in your doctor’s office from vaginal swabs, but no test is approved for testing males. The treatment is most commonly metronidazole (Flagyl). There is no agreement about the influence of Trich on fertility for males, but it may contribute to male factor infertility. There is, however, some evidence that Trich can affect a pregnancy causing low birth weight, premature rupture of membranes, or prematurity. Some studies have found an association between Trich and infertility, but overall, there is no strong evidence that Trich causes infertility.

Ureaplasma and mycoplasma are microorganisms that can affect different parts of the body, depending on the strain. The genital tracts of both sexes can carry mycoplasma or ureaplasma. The following list gives some other information about the diseases:

As many as 40 percent of women and men are carriers of bacteria called ureaplasma or mycoplasma.

Some controversy exists about whether certain strains of ureaplasma and mycoplasma cause problems in getting pregnant; some studies show that they increase the incidence of miscarriage and/or problems with the embryo implanting in the uterus. This seems to be related to either partner having the infection, which is easily passed between partners.

Scientific studies have failed to demonstrate statistically that either ureaplasma or mycoplasma reduces fertility.

As with other STDs, both partners are easily treated with a 14-day course of an antibiotic, such as doxycycline. Both partners must take the drug, or they’ll probably continue to reinfect each other.

Zika is a virus which can cause severe problems for infants if their mother becomes infected while pregnant.

The American College of Obstetricians and Gynecology (ACOG) issued a committee opinion in April of 2019 recommending that healthcare providers continue to caution patients about potential exposure to Zika even though the rate of infection seems to be decreasing.

Infectious agents come in basically four flavors: bacteria, yeast, parasites, and virus. The first three organisms all stay outside of the cell, but the virus enters the cell and hijacks the cell’s genetic machinery to turn out more virus — nice Trojan horse! Zika is spread to humans by mosquitos (Aedes species). Transmission of the virus has been reported to occur through sexual contact, blood transfusion, and to a fetus.

Since the virus is spread by mosquitos, which have defined habitats, areas where the mosquitoes reside are consider areas for possible exposure. The virus can also be contracted by having sex with an infected partner without the use of a condom. The signs of being infected include fever, rash, muscle aches, and inflammation of the eye. Symptoms usually occur within the first 3–14 days after exposure.

Zika has been classified as a fetal teratogen (something which causes a malformation of a fetus). If a fetus becomes infected, the fetus may develop a distinct pattern of birth defects which affect the nervous system, the brain, and the skull. Other problems have been reported as a result of a Zika infection such as heart abnormalities, miscarriage, preterm birth, and stillbirth. Women can transmit the virus to a fetus throughout a pregnancy, and the risk of a congenital birth syndrome is 5–10 percent.

As of 2019, there was no vaccine for Zika. Because the infection is from a virus, antibiotics do not work and there is no cure for the infection. That means that the only way to limit the risk of being infected is to avoid those areas where Zika lives. Thus, ACOG has made recommendations that include avoiding travel to areas where Zika outbreaks occur. Make sure to check before planning your next trip, even in you are in the preconception phase. Sorry, folks! Many of these Zika hot spots are in tropical oases (think Hawaii, the Caribbean, and so on). Keep in mind that skipping this babymoon may be the best gift you give to your future family.