Can BV Cause Infertility?
By Sarene Leeds
October 30, 2023
Vaginal infections, like all other infections, are no fun. But the last thing anyone wants to think about when dealing with a vaginal infection is whether or not their ability to conceive has been compromised.
Bacterial Vaginosis, or BV, is a common vaginal infection that, regrettably, has been linked to infertility. But this is due to a variety of factors: Even though BV doesn’t directly cause infertility, it can increase your risk of developing fertility issues. Plus, according to the American Pregnancy Association, BV is three times more common in infertile women than fertile women.
Before we delve into this topic further, however, it’s important to establish what exactly BV is.
What is Bacterial Vaginosis (BV)?
Bacterial Vaginosis is a medical condition where there is too much of a certain type of bacteria in the vagina, causing a bacterial imbalance. When the vagina is healthy, the “good” bacteria, known as lactobacilli, outnumber the “bad” bacteria, aka anaerobes. BV occurs when there are more anaerobes than lactobacilli.
While the cause of BV is unknown, this particular infection tends to show up in women who are sexually active. This is because researchers believe intercourse plays a role in changing the bacterial environment in the vagina. BV is also most common in women of reproductive age (from ages 15-44). Roughly 35% of women will get BV in their lifetime.
Although 84% of women who have BV don’t experience any symptoms, signs of BV can include discolored vaginal discharge (grey, white, or green), foul-smelling or “fishy” vaginal odor, vaginal itching, and burning during urination.
BV can also increase one’s chances of contracting a sexually transmitted disease or infection – and that’s when a link between BV and infertility develops.
Can Bacterial Vaginosis (BV) cause infertility?
Not directly. The association between BV and infertility occurs if a patient gets an STD or STI. Unfortunately, as we’ve already established, having BV does increase that risk. Sexually transmitted diseases/infections of the uterus or fallopian tubes “can have both short- and long-term fertility consequences,” says Sarah M. Moustafa, MD, Director of Oncofertility at CCRM Fertility and IRMS Reproductive Medicine.
While Dr. Moustafa confirms that BV doesn’t affect egg quality, this particular vaginal infection “increases the risk of pelvic inflammatory disease and damaged fallopian tubes,” which can lead to fertility issues.
Specific examples of potential fertility problems from BV-linked STD/STIs are as follows:
The fallopian tubes can become blocked due to scar tissue damage from infections. This means the sperm and egg can’t meet.
Increased inflammation and immune system activity create a toxic reproductive environment.
Damage to sperm and vaginal cells
How is BV treated – Will it affect my fertility?
Treatments for BV include either oral or vaginal antibiotics, the latter being a gel or cream you insert into your vagina. If you are diagnosed with BV, it’s imperative that you take your medication as prescribed by your doctor. “Treatment for BV is not going to harm one’s fertility,” assures Dr. Moustafa. But, “untreated BV can harm fertility,” as you will be at even greater risk for STDs like HIV, chlamydia, and gonorrhea. Dr. Moustafa also confirms that as long as your BV is treated, there shouldn’t be any “direct, long-term effects.” It’s imperative, however, to finish your treatment even if your symptoms have cleared up, and to hold off on sex until you’ve completed your course of antibiotics.
What if I’m TTC and I have BV?
If you’re trying to conceive and think you have BV, definitely get in touch with your OB/GYN or fertility doctor for treatment, advises Dr. Moustafa. Also, “if the condition reoccurs,” she says, “you may want to ask about the possibility of uterine or tubal infection, especially if you’ve had difficulty getting pregnant.”
Could BV affect my pregnancy?
It is absolutely possible to get BV while pregnant – and this diagnosis should never be taken lightly. “Women who are pregnant with BV have an increased risk of pregnancy complications, including a preterm birth, low infant birth weight, and early membrane rupture (water breaking),” warns Dr. Moustafa. So it’s important to contact your medical provider for diagnosis and treatment ASAP.
How can I prevent BV?
The best way to keep BV at bay is by not disrupting your “normal vaginal ‘good’ bacteria,” says Dr. Moustafa. So wash your vaginal area with warm water only. Dr. Moustafa also recommends that women reduce their risk of infection by “avoiding using anything in the vagina that is scented and would upset the body’s natural balance of germs, such as vaginal douches.” That means sticking to unscented pads, tampons, and soaps as well. Practicing safe sex can also lower your risk of BV and subsequent STDs/STIs. Make sure to use latex condoms or dental dams, clean any sex toys, and limit your number of sex partners.