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Dr.M.D.Mazumdar, Doctor
Category: OB GYN
Satisfied Customers: 9033
Experience:  MD (Obst&Gynecology)
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I was diagnosed with a chlamydia infection last year. I was

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I was diagnosed with a chlamydia infection last year. I was completely shocked because I had been in a monogamous relationship for a year and a half at that point and had been tested prior to entering the relationship.
My boyfriend at the time denied any infidelity and to this day I will never know the truth and have accepted it, although I have many reasons to suspect he was unfaithful. He tested negative for acute infection but an antibody test showed that he had been exposed to the bacteria at some point.
At the longest (worst case scenario) I had the chlamydial infection for 18 months (if I indeed did contract it at the beginning of the relationship). I had been mildly spotting between periods a few months leading up to the diagnosis but other than that did not have any symptoms.
I have been depressed for a year now thinking that my fertility is now doomed when I thought I had taken all of the proper precautions and have acted responsibly in my sex life. I can't get it out of my mind and I have felt pretty awful emotional (and dirty and gross) since the diagnosis. My question is - what are the chances that I have tubal infertility? To offer my some peace of mind, after the chlamydia was treated my doctor did an abdominal and intravaginal ultrasound and said they both looked perfect. She did mention though that under normal conditions you can't see the fallopian tubes well on an ultrasound but she advised against the hysterosalpingogram since it is invasive and would expose me to radiation and I am not currently trying to conceive.
I am 32 and single, now with a history of chlamydia (possibly for 18 months!) and I feel really hopeless about my fertility prospects. Can you please offer me some insight to better understand?
Welcome and thank you for your question. I am Dr.Mazumdar and I hope I'm able to help you with your medical problem today.
In most cases, chlamydia causes infertility only if it remains untreated for along time. This long time infection can damage the tubes causing blockage or scarring inside the tubes.
Also, all women with chlamydia do not have fertility issues - the immune system of different women work differently, similar to an allergy.
In your case, you could not have been infected with chlamydia for more than 18 months - possibly not long enough to have caused any damage. Any gross damage would have been picked up by the ultrasound , minor damages will need a hysterosalpingogram (HSG) for a diagnosis.
Normally, we do not advise a HSG in women unless they are planning to get pregnant. But in your case, since you are very anxious about your fertility and are feeling depressed, it will be better to go in for this test to rule out tubal damage.
Since you have received treatment, I doubt that you have any tubal damage.
I hope this helps.
To add to the above answer, the risks of infertility after a single episode of chlamydia infection is only about 5%.
Customer: replied 4 years ago.

Thank you, ***** ***** That information is comforting.

When you said "In most cases, chlamydia causes infertility only if it remains untreated for along time." How long is a long time?

The 18 months has been concerned. I keep thinking the infection had to have spread upwards in my reproductive tract during that time (but am hoping I'm wrong).

The normal ultrasound comforted me a great deal. But there could still be tubal damage not visible on the ultrasound? How invasive is an HSG? I don't want to put my body at any more risk of further damage/pain.

I am afraid that there is no exact time frame for when chlamydia will cause tubal damage. In women with a weak immune system, the damage can occur earlier while in women with a strong immune system, the damage may not occur for a long time. If you are generally healthy, it is possible that your immune system is quite strong and is able to resist damage for a considerable time. Recent studies has also indicated that chlamydial infection may not cause tubal damage at all.
Yes, all tubal damage are not visible on ultrasound. Even an HSG may not show up microscopic damage to the hair cells of the tubal cells.
In an HSG, a dye is injected into the reproductive tract and Xrays taken as it moves through the uterus and tubes. There is a risk of infection during the procedure, especially vaginal infections may spread up to the uterus and tubes. It is better not to do it as far as possible unless you are actively planning a pregnancy. The pros and cons of being very depressed about your fertility issues needs to be considered. If you are depressed enough to need medicines about it, then an HSG is advisable. Otherwise, it is better not to go through with it.
Customer: replied 4 years ago.

Thank you, ***** *****

I would prefer to not go through with the HSG unless I absolutely have to some day. The chlamydia infection has really hit me hard emotional but I am not at the point of taking medication or anything for it.

It certainly has turned me off of men and physical contact for a while but I am hoping that will change if I meet a trustworthy man some day.

So all in all you think the statistical chances of my having fertility issues from this are low, correct?

That is my final question.

the probability of you having fertility issues are quite low. recent studies would even suggest that it is nil.
I hope this helps.
Customer: replied 4 years ago.

Thank you for your help, Dr. Mazumdar. Have a good day.

You are welcome.
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