Herpes and Fertility: What You Need to Know

One question that has repeatedly come up from couples planning to conceive is the link between herpes and fertility.  If you are concerned that you might have genital herpes and worry that it could be affecting your fertility, it’s important to first get tested. Of course, when it comes to a herpes blood test accurate results do matter.  We like STDcheck online for their quick, confidential, accurate and affordable testing.

Note that this article is referring to genital herpes and not shingles, which is caused by the varicella-zoster virus. Varicella-zoster belongs to a group of viruses called herpes viruses, which includes the viruses that cause cold sores and genital herpes. This explains why shingles is also known as herpes zoster.

The varicella-zoster virus is different from herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2). The herpes simplex virus (HSV) causes cold sores or genital herpes, a sexually transmitted infection. This infection is more common than people think. The Centers for Disease Control and Prevention estimate that about 776,000 people in the United States contract new herpes infections annually.

To understand the link between genital herpes and fertility, we’ll look at what happens in women and men separately.

Genital Herpes in Women

Genital infection due to HSV-2 is more frequent among women than among men: 20.3% of women versus 10.6% of men aged 14 to 49 years have HSV-2. This is probably because the virus is more easily transmitted from men to women than from women to men during vaginal sex.

Symptoms

If you are infected with HSV, you are most likely not to have symptoms or have very mild symptoms could be mistaken for another skin condition. You might experience the following signs and symptoms:

  • Vesicles, or small blisters, on or around the genitalia, rectum, or mouth
  • Painful ulcers when the vesicles break
  • Itching or tingling around the genital or anal region
  • Pain when passing urine
  • Headaches
  • Flu-like symptoms such as fever, general body pain, or swollen glands (may occur during the first outbreak or episode)

Link Between Herpes and Fertility

Previously, it was thought that the herpes virus, especially HSV-2, could cause fertility problems only in men. Women trying to conceive were advised to have sex during their ovulation if they were not having an outbreak. It was more difficult for these women to conceive because they had to have intercourse around their symptoms.

In 2016, some researchers found human herpes virus 6A (HHV-6A) in the uterine lining of 43% of women with unexplained infertility; they did not find the virus in control women with at least one successful pregnancy. This was an important finding because this family of viruses could be a potential cause of infertility in women.

The investigators also reported that the infection was exacerbated by estradiol, a form of estrogen. In women, estradiol levels fluctuate during the menstrual cycle. High levels of this hormone may trigger an active infection in the uterus.

Additionally, the results suggested that HHV-6A infection of the uterine lining triggered an abnormal immune response, which subsequently caused a uterine environment that was less hospitable to a fertilized egg.

How to Reduce Your Risk of Getting Genital Herpes

Obviously, the only way for you to avoid a sexually transmitted infection (STI) is by not having sexual intercourse (vaginal, anal, or oral sex). For the vast majority of persons who are sexually active, the following can help decrease their likelihood of getting genital herpes:

  • Maintain a monogamous relationship (ideally mutual) with a partner who has been tested and has negative STI test results.
  • Have protective intercourse every time. However, note that condoms may not offer full protection from herpes because some herpes sores are found in areas that aren’t covered by a latex condom.
  • If your partner has genital herpes, they should seek professional advice and start treatment. Additional measures that you can take is avoiding sexual intercourse (vaginal, anal, or oral) when your partner is having an outbreak.

Available Treatments

Currently, no drug has been approved by the United States Food and Drug Administration for HHV-6A or HHV-6B. However, infectious disease specialists commonly recommend antiretroviral drugs such as cidofovir, foscarnet, and valganciclovir to treat HHV-6B reactivation in transplant patients.

Researchers have not yet determined whether antiviral therapy would be beneficial in women with this uterine infection.

Genital Herpes in Men

Approximately 20% of men have genital herpes, and most do not even know they have the infection. In fact, it is estimated that about 85% of persons in the United States are unaware they have genital herpes.

Symptoms

These are similar to those experienced by women, except that pain from passing urine over the sores is commonly experienced by women.

Relationship Between Herpes and Fertility

Several herpesviruses, including HHV1,  HHV4, HHV5, and HHV6, have been implicated in male infertility. Studies have shown that men with herpes infection have a lower semen density as well as lower sperm count and motility than those without the infection. However, sperm counts, density, and sperm motility vary between HSV carriers and non-carriers across studies and virus types.

In one study, researchers detected HSV-1 in 24% of semen samples from infertile men. Additionally, another report showed that HSV was detected in 49.5% of semen samples, and infection with the virus was significantly related to low sperm count and poor sperm motility.

What Should You Do If You Have Genital Herpes

If you think you’re experiencing the symptoms of a beginning herpes outbreak, you should consult a health professional for the best advice.

Are you embarrassed to talk to a professional directly? You can have a private consultation online and stay anonymous. Several online clinics can be easily found via a simple Google search. Some clinics even offer patients the possibility of ordering an STI test kit that includes a herpes swab test.

Treatment

In addition to living a healthy lifestyle, some treatments can help prevent frequent outbreaks. An antiretroviral drug such as acyclovir can decrease the duration and frequency of herpes outbreaks. Acyclovir can also decrease the risk of transmission to a susceptible partner.

If you are worried you might have herpes, the first thing you should do is get tested.  And when it comes to a herpes blood test accurate results do matter.  It is also important to consider your feelings and privacy, which is why we like STDcheck.

Related: If are concerned about fertility and you liked this post, you might also our Modern Fertility review.

Medical disclaimer: The authors of this website are not medical professionals, and all of the material on this Site (including: text, images, graphics, outcomes, charts, messages and any other material) are for informational purposes only and are not a substitute for professional medical advice, diagnosis or treatment. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be interpreted to indicate that use of any drug is safe, appropriate or effective for you or anyone else. Always consult your doctor, physician or other licensed healthcare provider before taking any drug, making modifications to your diet, starting or discontinuing your treatment, or with any questions or concerns you have regarding your health. Never ignore or disregard medical advice or delay seeking medical advice because of something you read on this Site. Reliance on any material provided on the Site is solely at your own risk. Any application of the material provided is at your own risk and is your sole responsibility.

Further Reading

  1. Satterwhite CL, Torrone E, Meites E, et al. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis, 2013. 40(30):187-93.
  2. Fanfair RN, Zaidi A, Taylor LD, Xu F, Gottlieb S, Markowitz L. Trends in seroprevalence of herpes simplex virus type 2 among non-Hispanic blacks and non-Hispanic whites aged 14 to 49 years–United States, 1988 to 2010. Sex Transm Dis, 2013. 40(11):860-4.
  3. Corey L, Wald A. Genital Herpes. In: Holmes KK, Sparling PF, Stamm WE, et al. (editors). Sexually Transmitted Diseases. 4th ed. New York: McGraw-Hill; 2008: 399–437.
  4. Wald A, Zeh J, Selke S, et al. Reactivation of genital herpes simplex virus type 2 infection in asymptomatic seropositive persons. New Engl J Med, 2000. 342(12): 844–50.
  5. Kimberlin DW, Rouse DJ. Genital Herpes. N Engl J Med, 2004. 350(19): 1970–7.
  6. Marci R, Gentili V, Bortolotti D, Lo Monte G, Caselli E, Bolzani S, Rotola A, Di Luca D, Rizzo R. Presence of HHV-6A in Endometrial Epithelial Cells from Women with Primary Unexplained Infertility. PLoS One. 2016 Jul 1;11(7):e0158304. doi: 10.1371/journal.pone.0158304.
  7. Tronsteinrpesic Infection. JAMA. 2011;305(14):1441–1449. doi:10.1001/jama.2011.420.
  8. BezoldJArsJmissiblec male infertility patients with and without leukocytospermia. Fertil Steril 2007; 87: 1087–1097.
  9. Neofytou E, Sourvinos G, Asmarianaki M, Spandidos DA, Makrigiannakis A. Prevalence of human herpes virus types 1–7 in the semen of men attending an infertility clinic and correlation with semen parameters. Fertil Steril 2009; 91: 2487–2494.
  10. Salehi-vaziri M, Monavari SH, Khalili M, Shamsi-Shahrabadi M, Keyvani H, Mollaei H, Fazlalipour M. Detection of HSV-1 DNA in the semen of infertile men and evaluation of its correlation with semen parameters in Iran. Iranian J Virol 2010; 4: 1–6.
  11. Naumenko VA, Tiulenev IA, Pushkar’ DI, Segal AS, Kovalev VA, Kurilo LF, Shileĭko LV, Klimova RR, Al’khovskiĭ SV, Kushch AA. Effect of herpes simplex virus on spermatogenesis. Urologiia 2011; Nov-Dec: 32–36.
  12. Monavari SH, Vaziri MS, Khalili M, Shamsi-Shahrabadi M, Keyvani H, Mollaei H, Fazlalipour M. Asymptomatic seminal infection of herpes simplex virus: impact on male infertility. J Biomed Res. 2013 Jan;27(1):56-61. doi: 10.7555/JBR.27.20110139.
Princila
 

I’m Princila, founder of Check Ovulation and a proud mom of two. I’m an alumna of James Lind Institute. After working in clinical jobs, my passion for writing took its toll, and I ended up switching careers to work in the medical publishing industry. I also have a passion for healthy food, which prompted me to take several online courses in nutrition and health offered by Wageningen University. (I still haven’t completed the courses thanks to my busy mommy schedule!). When I’m not writing/editing scientific and medical manuscripts or taking care of my family, I use my free time to research, learn, and write about healthy living. I have also authored a few books in the self-help niche using the pen names Princila Murrell or PN Murray.

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