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PubMed This is a summary of 21 peer-reviewed journal articles Updated
Infectious Disease

Does Schistosomiasis Cause Permanent Infertility?

At a Glance

Schistosomiasis does not always cause permanent infertility. Prompt treatment with the medication praziquantel clears the parasite and prevents lasting damage. However, if left untreated for years, it can cause severe scar tissue that blocks reproductive pathways, making natural conception difficult.

In this answer

3 sections

01

How Schistosomiasis Affects the Reproductive System

02

The Importance of Prompt Treatment

03

Moving Forward: Building Your Care Team

Schistosomiasis can affect fertility, but it does not always cause permanent infertility. The condition is caused by a waterborne parasite, not a sexually transmitted infection (STI) [1][2][3]. The parasite’s eggs can become trapped in the reproductive organs, triggering chronic inflammation [1][4]. Over time, this inflammation can lead to tissue scarring (fibrosis) [1][4]. If you are treated promptly with antiparasitic medication, permanent damage can often be prevented [5][6]. However, if the infection goes untreated for months to years, the resulting scar tissue can cause blockages that may permanently affect the ability to have children naturally [7][8].

How Schistosomiasis Affects the Reproductive System

When the Schistosoma parasite (such as Schistosoma haematobium) infects the body, it lays eggs that can lodge in the tissues of the reproductive tract [1]. Your immune system reacts to these trapped eggs, creating clusters of inflammatory cells called granulomas [1][4].

If the infection continues without treatment, this constant immune response gradually replaces healthy tissue with stiff scar tissue [9][10]. This process is what ultimately threatens fertility. Symptoms of active infection that warrant prompt evaluation include bloody urine (hematuria) and pelvic pain [11][12][13].

Female Genital Schistosomiasis (FGS)

In women, the trapped eggs and resulting scar tissue can damage the fallopian tubes, cervix, and vagina [4][14].

  • Tubal Blockages: Scar tissue can narrow or completely block the fallopian tubes, making it difficult or impossible for an egg to meet sperm [4][14].
  • Ectopic Pregnancy: If the tubes are partially blocked or damaged, a fertilized egg might get stuck and grow outside the uterus, which is a life-threatening emergency called an ectopic pregnancy [4][14].
  • Increased Infection Risk: It is important to note that FGS causes genital lesions that can increase the risk of acquiring HIV and other STIs, making early treatment essential for overall health [2][3].

Male Genital Schistosomiasis (MGS)

In men, the infection can affect the prostate, seminal vesicles, and other parts of the reproductive tract [15][16].

  • Pathway Blockages: Similar to women, scarring can block the tubes that transport sperm [15][16].
  • Hormonal and Semen Changes: MGS has been associated with reduced testosterone production and can negatively impact overall semen quality [17][15].

The Importance of Prompt Treatment

The standard treatment for schistosomiasis is a prescription medication called praziquantel [18][1].

  • Early Treatment: When given early, praziquantel effectively kills the parasites, stops the production of eggs, and halts the inflammatory process before severe scarring can occur [5][6].
  • Late Treatment: While praziquantel cures the active infection and stops further damage, it generally cannot reverse fibrotic scar tissue that has already formed over years of chronic infection [5][19].

Moving Forward: Building Your Care Team

If you have a history of genital schistosomiasis and are struggling to conceive, it is important to know that you still have options. Because visual signs of FGS can be subtle or mistaken for other conditions, accurate diagnosis and specialized care are essential [20][21].

If you suspect you have chronic scarring, a reproductive specialist (endocrinologist or fertility specialist) can evaluate the extent of the damage. They may suggest surgical interventions to clear blockages or recommend Assisted Reproductive Technology (ART), such as In Vitro Fertilization (IVF), which bypasses damaged reproductive pathways entirely [20][10].

Common questions in this guide

Can you still get pregnant after having schistosomiasis?
Yes, many people can still get pregnant after a schistosomiasis infection. If treated early, permanent reproductive damage is usually avoided. Even if long-term scarring has occurred, fertility treatments like In Vitro Fertilization (IVF) can bypass the damage and help you conceive.
How does schistosomiasis cause infertility in women?
In women, the parasite's eggs can become trapped in the reproductive organs, triggering chronic inflammation. Over time, this creates stiff scar tissue that can narrow or completely block the fallopian tubes, making it difficult or impossible for an egg to meet sperm.
Does schistosomiasis affect male fertility?
Yes, male genital schistosomiasis can cause scarring that blocks the tubes responsible for transporting sperm. It has also been associated with reduced testosterone production and can negatively impact overall semen quality.
Can medication reverse the fertility damage caused by schistosomiasis?
The medication praziquantel effectively cures the active parasitic infection and stops further damage from occurring. However, it generally cannot reverse fibrotic scar tissue or reproductive blockages that have already formed from years of untreated infection.
What tests can check for fertility damage from schistosomiasis?
A reproductive specialist may recommend specific imaging tests, such as a hysterosalpingogram (HSG), to check for blockages in a woman's fallopian tubes. For men, a semen analysis is typically used to evaluate sperm quality and check for potential pathway blockages.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Are there specific tests, like a hysterosalpingogram (HSG) or a semen analysis, that we should perform to check for blockages or tissue damage?
  2. 2.How can we determine if my past schistosomiasis infection is currently affecting my fertility?
  3. 3.Should I be referred to a reproductive endocrinologist or fertility specialist to explore options like ART or surgery?
  4. 4.Are there any active signs of inflammation or infection that still need to be treated with praziquantel?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

Related questions

Can Organ Damage From Schistosomiasis Be Reversed?Can Schistosomiasis Tests Give False Negatives?Can You Catch Schistosomiasis From Drinking Water?Can You Get Schistosomiasis More Than Once?How Long Can Schistosomiasis Survive Untreated?Is Schistosomiasis Sexually Transmitted?What Are Praziquantel Side Effects for Schistosomiasis?Where Do Schistosomiasis Parasites Go After Treatment?When Should I Test for Schistosomiasis After Traveling?

References

References (21)
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    Schistosomiasis endemicity and its role in sexually transmitted infections - a systematic review and meta-analysis.

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    Prevalence, Intensity, and Factors Associated with Urogenital Schistosomiasis among Women of Reproductive Age in Mbogwe District Council, Geita Region, Tanzania.

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This page provides educational information about how schistosomiasis affects fertility. It is not a substitute for professional medical advice, diagnosis, or treatment from a fertility specialist or infectious disease doctor.

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