Sexually transmitted diseases and infertility.

In the past decade, involuntary childlessness has become a major problem in many areas of the world. At the same time evidence confirms a link between sexually transmitted diseases (STDs) and the burgeoning infertility problem. STDs can adversely affect fertility by three primary mechanisms: (1) pregnancy wastage; (2) neonatal deaths; and (3) obstruction of either male or female reproductive ducts. STD control programs have been effective in preventing sequelae of disease, including infertility. The first step in developing such a program is to identify the magnitude and distribution of the problem, and to identify the specific agents most commonly involved. Subsequently, an STD control program emphasizing the prevention of infertility, can be incorporated into the existing health care system whenever STDs are an important cause of infertility.