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Patient is undecided about pregnancy - Sexually Transmitted Infections and Diseases


  • Scope: Infectious diseases, and particularly sexually transmitted infections or diseases (STIs or STDs) can affect the health and development of the woman and child. In addition, some STDs do not show symptoms and can affect a woman’s ability to get pregnant. About 20 million new cases of STDs are reported each year, about half occur in those ages 15 -24.

    These infections include:

    • Bacterial Vaginosis (BV)

    • Chlamydia

    • Cytomegalovirus (CMV)

    • Gonorrhea

    • Hepatitis

    • Herpes

    • HIV/AIDS

    • Human Papillomavirus (HPV)

    • Influenza

    • Pelvic Inflammatory Disease (PID)

    • Rubella

    • Streptococcus (Group B)

    • Syphilis

    • Tetanus, Diphtheria, Pertussis (Tdap)

    • Trichomoniasis

    • Varicella (Chicken Pox)

    • Zika

  • Preconception Significance:

    • Infertility: Chlamydia and gonorrhea are important preventable causes of pelvic inflammatory disease (PID) and infertility. Chlamydia can cause fallopian tube infection without any symptoms. PID and infection in the upper genital tract may cause permanent damage to the fallopian tubes, uterus, and surrounding tissues, which can lead to infertility. CDC recommends annual chlamydia and gonorrhea screening of all sexually active women younger than 25 years, as well as older women with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection.

      See CDC on Infertility and STDs for more info on STDs and Infertility.

    • Risks and Treatment: Sexually transmitted infections pose important risks for reproductive health (e.g. infertility) and childbearing which makes them especially important to address before pregnancy is attempted or achieved.

      Some vaccines to these infectious diseases contain a live virus and cannot be used in pregnancy. The treatments for some infectious diseases pose physiological risks for the fetus, which means treatment must happen before conception to avoid this risk.

      See CDC on Pregnancy and STDs for more info on STDs and pregnancy.

  • Risk Identification Strategies:

    • Clinician: A complete medical and sexual history should be obtained for all women to identify risk and exposures. Immunization records should be obtained for review and counseling on risky behaviors can be used as an added strategy to identify risk.

    • Patient: A person is at risk for an STD by being sexually active. Most are spread through sex (anal, vaginal, or oral), while other such as herpes and HPV, are spread through skin-to-skin contact. More risks include: women’s bodies are biologically more susceptible to STDs, not getting the recommended STD tests and screenings, and having more than one sex partner.

      See CDC on STD Risk and Oral Sex for more info on risk and oral sex.

Page Updated: 8/15/2017