Infertility and sexually transmitted disease: Major problems in maternal and child health and family planning

Greater attention is being paid to the control of STDs due to their increasing prevalence and adverse longterm effects. Infertility rates above the core 5% to 7% attributed to genetic anatomic and endocrine factors are generally due to infection. Additional longterm complications include ectopic pregnancy sepsis arthritis and neonatal illness. Historically the importance of organisms has varied with resistant gonococci chlamydia and HIV among the more prominent organisms currently. Case reporting of STDs is critical for control but notoriously poor making comparison of data difficult. In all countries it is axiomatic that prostitutes have the highest rates of STDs. Young adults and older adolescents are groups at risk. It is uncertain whether the prevalence of infertility worldwide is changing. It appears that infertility rates in areas where infertility was considered epidemic are declining while infertility rates may be rising in areas that used to have a low incidence. Maternal and child health and family planning services may be an appropriate means of controlling STDs. STDs have a significant impact on maternal and infant health. The major difficulty in incorporating screening for STDs into these programs is cost. Simple less costly screening techniques could probably be developed easily. Furthermore in light of the long term costs of the sequelae of STDs to these programs such screening could be a cost effective measure for them.