Unprotected Sex, Chlamydia and Infertility Leah Fowler Tyler McGrath Meg Celidonia

Unprotected sex Little or no use of a condom Little or no use of a condom Can lead to repeated infection of the host Can lead to repeated infection of the host Can be very difficult to get rid of Can be very difficult to get rid of Discontinuing of antibiotics Discontinuing of antibiotics Repeated encounters with infected individual Repeated encounters with infected individual

Chlamydia Caused by Chlamydia trachomatis Caused by Chlamydia trachomatis 1.4 million cases reported in the US in million cases reported in the US in 2012 Estimated 2.86 million new infections a year Estimated 2.86 million new infections a year Estimated 1 in 15 sexually active year old females are infected Estimated 1 in 15 sexually active year old females are infected Epiandbiostats.net Eggandspermrace.com

A “Silent” Disease 95% of males and 75% of females have no symptoms Possibly dysuria or vaginal/urethral discharge Possibly dysuria or vaginal/urethral discharge Janinehuldie.com

Pathology Host epithelial cells infected Host epithelial cells infected Inflammatory response initiated Inflammatory response initiated Neutrophils and monocytes respond Neutrophils and monocytes respond T cells control the infection T cells control the infection Tubal damage is done Tubal damage is done Possible infertility Possible infertility

Management Easily treated with antibiotics Easily treated with antibiotics Erythromycin or Azithromycin Erythromycin or Azithromycin Both partners must be treated Both partners must be treated Possible reinfection Possible reinfection Medimoon.com

Host Induced Immunity Happens but is ineffective Happens but is ineffective Possible reasons: Possible reasons: Short lived Short lived Long development time Long development time Prevented due to antibiotic interference Prevented due to antibiotic interference Taylor & Haggerty, 2002

Vaccines Long term immunity has been tested but has been ineffective Long term immunity has been tested but has been ineffective The best way to make a vaccine: The best way to make a vaccine: Make one that stimulates the current immune response in hopes of it being more effective and longer lasting. Make one that stimulates the current immune response in hopes of it being more effective and longer lasting. More research needs to be done for more effective methods More research needs to be done for more effective methods Taylor & Haggerty, 2002

Treatment for both (EPT) Expedited Partner Therapy program (EPT) Expedited Partner Therapy program Implemented in 27 states Implemented in 27 states When a case is found: When a case is found: Antibiotics are prescribed for the partner Antibiotics are prescribed for the partner Done without any exam on them Done without any exam on them

If left untreated… Females - may cause Pelvic Inflammatory Disease (PID), ectopic pregnancy and infertility Females - may cause Pelvic Inflammatory Disease (PID), ectopic pregnancy and infertility Males - may cause epididymitis, impaired sperm production and infertility Males - may cause epididymitis, impaired sperm production and infertilitycdc.gov

Smashinglist.com Sexandyeastinfection.com

Infertility The effects of infertility go far beyond the inability to conceive The effects of infertility go far beyond the inability to conceive Physical Being infertile Scarring of the epididymis or fallopian tubes Possible pain (PID) Emotional Diminished quality of life Sorrow Powerlessness Akande, Turner, Horner, Horne & Pacey, 2010 Emotionalaffair.org

Infertility in Males Infertility originally focused on females Infertility originally focused on females Research has shown the effects are the same in the male and can lead to: Research has shown the effects are the same in the male and can lead to: Poor sperm quality Poor sperm quality Immobile sperm Immobile sperm Premature sperm apoptosis Premature sperm apoptosis Scarring of the ejaculatory ducts Scarring of the ejaculatory ducts Inhibition of spermatogenesis Inhibition of spermatogenesis Akande, Turner, Horner, Horne & Pacey, 2010

Testing and Screening Due to the lack of symptoms screening is rare and treatment may be too late Due to the lack of symptoms screening is rare and treatment may be too late Labs done within hours Labs done within hours Testing: Testing: Urine Urine Swabs Swabs Safesexnoregrets.nt.gov

Health Promotion/Prevention Targeted age group should be screened Targeted age group should be screened Education is key Education is key If sexually active: If sexually active: Wear a condom or dental dam Wear a condom or dental dam Be monogamous with someone that does not have a chlamydia infection Be monogamous with someone that does not have a chlamydia infection cdc.gov

NHS

Shoutmeloud.com

References Ackley, B., & Ladwig, G. (2006). Nursing diagnosis handbook. (7th ed., p. 78). Philadelphia, PA: Mosby Inc. Akande, V., Turner, C., Horner, P., Horne, A., & Pacey, A. (2010, September). Impact of Chlamydia trachomatis in the reproductive setting: British Fertility Society Guidelines for practice. Human Fertility, 13(3), doi: / CDC Grand Rounds: Chlamydia Prevention: Challenges and Strategies for Reducing Disease Burden and Sequelae [Electronic version]. (2011, April 1). MMWR: Morbidity & Mortality Weekly Report, 60(12),

References Centers for Disease Control and Prevention. (2014, February 13). Infertility. Retrieved from Darville, T., & Hiltke, T. (2010). Pathogenesis of genital tract disease due to chlamydia trachomatis. Journal of Infectious Diseases, 201(2), Navarro, C., Jolly A., Nair, R., & Chen, Y. (2002). Risk factors for genital chlamydial infection. The Canadian Journal of Infectious Diseases, 13(3), Retrieved March 25, 2014, from the NCBI database. Taylor, B. D., & Haggerty, C. L. (2011, January 19). Management of Chlamydial trachomatis genital tract. Infection and Drug Resistance, doi: /IDR.S12715

References Stds & infertility. (2013, 10 30). Retrieved from cdc.gov/std/infertility