Rwanda Biomedical Centre (RBC) has announced plans to conduct study on the status of Sexually Transmitted Infections (STIs) impact on fertility in Rwanda. Dr Charles Berabose, in charge of HIV, Hepatitis and other infectious diseases treatment at RBC, said the number of people found with Sexually Transmitted Infections, apart from HIV and Hepatitis, has increased from 2.7 percent in 2015 to 4.2 percent in 2022 warning that such infections can cause infertility. The report shows that between 4.8 million individuals and 6.6 million individuals have been screened for STIs per year since 2015. Of these, it shows that 2.7 percent were confirmed positive in 2015, 2.5 percent in 2016, 2.6 percent in 2017, 2.4 percent in 2018, 3.1 percent in 2019, 4.7 percent in 2020, 4.5 percent in 2021 and 4.2 percent in 2022. The report presented to journalists also indicates 119,716 vaginal discharge cases, 18,156 genital ulcers cases, 1,413 inguinal bubo cases, 3,665 cases of painful swelling of epididymis (tubes behind tests) and testis, 57,851 cases of urethral discharge (any type of discharge or liquid, besides urine or semen, that comes out of the opening of the penis) in men, 30,160 pelvic inflammatory (infection of the female reproductive organs) syndrome cases were recorded between 2021 and 2022. How STIs can cause infertility Such sexually transmitted diseases can directly or indirectly cause infertility in women and men, according to medical doctors. When the sexually transmitted diseases are left untreated, infections can develop and cause infertility by moving up the reproductive system and spreading to the woman’s uterus, ovaries and fallopian tubes causing damage, scarring or inflammation. Studies show that problems with the fallopian tubes cause about 30 percent of female infertility. They show that Pelvic inflammatory Disease (PID), an infection commonly caused by sexually transmitted diseases, can lead to tubal factor infertility as well as damaging the ovaries, which can also contribute to infertility. Some sexually transmitted diseases such as gonorrhoea and chlamydia, can affect fertility in men and women as these often go unnoticed due to lack of symptoms, resulting in more damage. The major causes of sexually-related infertility for women are pelvic inflammatory disease (PID) and damage to the fallopian tubes. Gonorrhea can thrive in a female’s uterus and the fallopian tubes causing infertility. In males, gonorrhoea can cause the sperm ducts to become inflamed, called epididymitis. If left untreated, this can cause male infertility as it prevents sperm from entering the female during intercourse. Syphilis, if left untreated for mothers, can be passed to their unborn babies according to studies. Women with untreated syphilis who become pregnant have a 50 percent chance of miscarriage or stillbirth, which has a direct impact on the ability to have a child. Although syphilis doesn’t have a direct effect on male fertility, complications from the disease can cause epididymitis. Scarring of the sperm ducts from this condition can prevent sperm from being released during ejaculation, causing male infertility. If syphilis goes untreated for a long period of time, the disease can begin degenerating nerves and eventually lead to erectile dysfunction. “The sexually transmitted infections can finally cause infertility because babies can’t grow in such damaged parts or viruses,” Berabose said. Research plans underway “The diseases affect both men’s and women’s infertility. In Rwanda, we have not yet conducted the study to know a number of infertility cases that might have been caused by sexually transmitted infections. However, we are planning to conduct such a study. The study is complex as it will take time to discover. We are in preparation for the study,” he said. He urged people to go for screening at an early stage for early treatment as soon as they observe symptoms. “If people delay going for screening, treatment delays. If they do not recover, they could face effects including infertility,” he noted. Alain Zimulinda, an Infection Prevention and Control (IPC) Specialist, noted that if such infections do not show symptoms, “it becomes worse because you can spread them without knowing. The top infections are caused by syphilis, gonorrhoea, chlamydia and trichomonas and others.” “These infections are causing infertility and are causing pregnancy complications. Studies show that 20 percent of such infections globally happen in Africa,” he said
