It is impossible to become pregnant at the husband a mycoplasmosis. Is it possible to get pregnant with ureaplasma, does ureaplasmosis interfere with conception? What danger does the disease carry: consequences for mother and child during pregnancy

Among the infectious agents genitourinary system there are some that can be considered a real scourge human population. At the end of the 20th and the beginning of the 21st centuries, clinical studies were conducted among women suffering from inflammatory processes in the urogenital area for a long time. In laboratory diagnostics, in 40–46% of cases, microorganisms belonging to the group of mycoplasmas were isolated, namely Ureaplasma urealyticum and Mycoplasma hominis.

It turns out that almost half of the female population of the planet with chronic inflammatory processes of the genitourinary sphere, to one degree or another, is affected by microbes with a complex name. How dangerous is it? How does this situation affect reproductive health? And what to do with it in the end?

Exciter characteristic

Mycoplasmas are distinguished from the background of other bacteria by the absence of a cell wall: their poor inner world delimited from environment only one cytoplasmic membrane. Probably, this factor affects the fact that it is difficult for the immune system to fight them: there are no expressed antigens, which are usually located in the bacterial cell wall. Therefore, the human immune system reacts sluggishly to this microbe: white blood cells “see” it poorly and do not destroy it.

Varieties

The mycoplasma family is very diverse. It includes more than a hundred varieties of bacteria. Some are dangerous to birds, others to animals. As for a person, the most significant are the following subspecies:

1. Mycoplasma pneumoniae.
2. Mycoplasma hominis.
3. Mycoplasma genitalium.
4. Ureaplasma urealyticum.
5. Ureaplasma parvum.

The pathology of the urogenital system is caused by all but the first. And, although these bacteria are conditionally pathogenic, that is, absolutely healthy people can be their carriers, in many women and men they also cause sluggish inflammatory processes in the area of ​​the genitourinary system.

Epidemiological indicators

Despite the fact that among women with gynecological pathology, many suffer from manifestations of ureaplasmosis, not all are infected. The optimism is added by the fact that among all women the proportion of infected people fluctuates around 8%. The increased risk of infection is associated with a number of factors:

• Young age.
• Frequent change of sexual partners.
• Low socio-economic status.
• The use of oral contraceptives (provokes unprotected sex).
• Belonging to the African American people.

Let us make a reservation right away that in most people the very fact of infection does not manifest itself in any way. Bacteria simply live in the mucous membranes of the urogenital tract without causing disease, and are found only in laboratory tests for an external reason.

This feature gave rise to classify genital mycoplasmas as opportunistic pathogens.

Diseases caused

So, most carriers have no symptoms. But with weakened immunity or repeated massive infection, the number of bacteria increases and becomes critical. Then incomprehensible inflammatory processes can begin, to establish the true cause of which is not at all easy. A sick woman can develop almost any genital pathology:

• Nongonococcal urethritis.
• Nonspecific vaginitis.
• Endometritis.
• Salpingitis.
• Cervicitis.

Simply put, mycoplasmal inflammation can affect all reproductive organs: the vagina, ovaries with appendages, the cervix and the uterus itself. Given the prevalence of the microbe, many women have a logical question: is it possible to get pregnant with ureaplasma?

Impact on the ability to become a mother

Any woman who wants to have a child will be worried if she is diagnosed with genital mycoplasmosis. Everyone knows that the pathology of the reproductive system most often adversely affects the ability to conceive, bear and give birth to a normal child. healthy baby. Let's figure out how ureaplasmosis can prevent a carrier woman from getting pregnant and having a baby.

Opportunity to get pregnant

By themselves, mycoplasmas have no effect on the egg, hormonal background do not violate. Seemingly harmless, right? But let's remember the list of diseases that can be provoked by ureaplasma.

Long-term sluggish chronic inflammatory processes always cause changes in the affected organs. Therefore, difficulties with conception can arise if the ovaries are affected, and also on both sides.

Inflammatory changes lead to violations of egg maturation, provoke the appearance of cysts, cause a violation of the patency of the fallopian tubes. Clinically, this is manifested by menstrual cycle which always interfere with normal conception.

Chronic cervicitis (inflammation of the cervix) can lead to impaired patency of the cervical canal for spermatozoa. Vaginitis with its unpleasant symptoms can cause persistent psychological rejection of sexual activity.

The result of all is that the egg, for one reason or another, does not leave the ovary and / or is not fertilized. So indirectly implemented Negative influence ureaplasma for conception.

Ability to endure

From the side of the uterus, too, there are enough troubles. Long-term presence of mycoplasmas in the mucous membrane of the uterus (endometrium) causes quite pronounced changes in it. Up to the point that the attachment of the embryo to the wall of the uterus becomes difficult. And even if the delay has come, a quick test showed two stripes, then it’s too early to relax.

Statistics show that women with active mycoplasma infection require increased attention from the antenatal clinic. They are more likely to experience a variety of pregnancy disorders:

• Kidney dysfunction, which increases the likelihood of toxicosis.
• The threat of abortion is especially high in the first 12 weeks.
• Fetoplacental insufficiency (disturbances in the mother-placenta-fetus system).
• Anomalies associated with amniotic fluid.
• Extragenital pathology (in the first place - diseases of the urinary tract).
• Anemia of varying severity.
• premature birth.

If we compare the activity, then Ureaplasma urealyticum provokes all of the above more often than Mycoplasma hominis. A bit of optimism is added by the fact that the probability negative phenomena decreases in proportion to the number of active microorganisms. Therefore, it still makes sense to undergo a laboratory examination for this infection before pregnancy.

If the fact of carriage is detected, then it is useful to determine the degree of influence of microbes on the mother's body.

Effect on the fetus

For the period of pregnancy, mother and fetus form a single whole, interconnected through the placenta and umbilical cord. Children's place- a good natural filter that protects the embryo from many troubles, including bacteria.

Active infection can overcome this barrier, moreover, it is able to infect the placenta. It is clear that this does not mean anything good for the fetus. Fetoplacental insufficiency occurs with active ureaplasma much more often than in clinically healthy women. This entails fetal malnutrition, developmental anomalies, which can lead to congenital mycoplasmosis. The most pessimistic outcome is fading and miscarriage.

The passage of the fetus through the birth canal often leads to infection, and in infants immediately after birth, pneumonia begins, a common mycoplasmosis.

This is usually not observed if a woman responsibly prepares for childbirth: she is regularly examined, sanitizes the birth canal.

A direct relationship has been found between the risks to the fetus and the degree of mycoplasma activity: large numbers of bacteria lead to disorders much more often than simple asymptomatic carriage.

Diagnostics

Asymptomatic carriage of mycoplasmas in the body is detected during preventive examinations. Usually, a swab-scraping from the urethra and genitals is enough for this. Microscopic examination of this material allows you to detect ureaplasmas and conclude whether the woman is infected. And about species affiliation it is impossible to say right away, sowing on nutrient media is required, followed by the study of the grown culture.

The popularity of microscopy is due to the fact that it is simple and cheap. Because of this, it refers to screening (quick) diagnostic methods. It will be especially helpful:

• To all pregnant women.
• Women who are just planning to become a mother.
• Those couples who have not been able to conceive a child for several months.
• Patients with episodes of miscarriage or pathology of pregnancy in the past.

Negative results should not relax. It happens that there are mycoplasmas, but their small amount interferes with the correct diagnosis: they simply do not fall into the smear. If the microscopy result is negative, the doctor may recommend additional laboratory testing for the patient at increased risk of infection.

The method is based on PCR (polymerase chain reaction). A very sensitive and accurate method determines the smallest amount of microorganisms.

In addition, this is the only way to detect Mycoplasma genitalium: this variety is very poorly cultivated.

For analysis, blood is taken from a vein. Searched for in serum genetic material ureaplasma and, if detected, it is possible to accurately determine the type of bacteria. It becomes possible to draw indirect conclusions about the activity of the infection. High rates may be a recommendation for the appointment of antimicrobial agents.

Therapeutic activities

We note right away that the detection of ureaplasmosis is not a reason to despair. Is it possible to get pregnant with ureaplasma? Not only possible, but necessary. Early diagnosed infection is treated quite well. True, the uncontrolled use of antibiotics inevitably led to the emergence of strains resistant to certain agents.

Cultural examination provides material to determine the most active drugs. Sufficient efficiency is shown by:

• Tetracyclines (high chance of resistance).
• Macrolides (resistance is very likely).
• Lincosamides (high sensitivity).
• Aminoglycosides (high sensitivity).

Because of this, self-medication can be ineffective and even dangerous. Only after laboratory diagnosis can an effective treatment regimen be prescribed with confidence. Which usually includes at least two antimicrobial agents.

And then the problem of conception with ureaplasma significantly reduces its relevance. Effective treatment guarantees a safe pregnancy and the birth of a healthy baby.

Very often, when undergoing a microflora examination when planning a pregnancy, a woman is diagnosed with ureaplasmosis. The first thing that interests the patient in this case is “is it possible to get pregnant with ureaplasma?”. According to experts, ureaplasma prevents pregnancy, which is confirmed in the course of finding out the reasons for unsuccessful attempts to conceive a child by young couples for a long time. In more than 22% of couples, this bacterium causes male or female infertility. Such data allow us to answer with confidence: “of course it interferes”, to the question “does ureaplasma interfere with getting pregnant”.

If we talk about female infertility, then the reason why it can be quite difficult to get pregnant with ureaplasma is that this disease manifests itself only if the carrier's immunity decreases. This, in turn, makes it possible to simultaneously develop several infections at once, which, affecting the genitourinary tract, cause inflammatory processes that stimulate the development of each other. Worst of all, if ureaplasmosis develops in conjunction with gonorrhea or chlamydia, in this case, with ureaplasma, it will be possible to become pregnant only if the active process of adhesion formation has not begun in the fallopian tubes. It is with the problems of the fallopian tubes that more than half of the cases of female infertility are associated.

However, even with the development of a single infection, the assertion is rather controversial that with ureaplasma you can get pregnant easily and without any problems. The problem is the inflammatory process in the foci of bacterial development.

No less acute is the dilemma of whether it is possible to get pregnant with ureaplasmosis, with a partner. This disease is a transmissible sexually, while the chance of infection is so high that most women of reproductive age have these microorganisms in an opportunistic form. That is, there is a risk of becoming infected from a partner, and transmitting the infection to the fetus. And the conception itself will be at risk, since the bacterium is able to imperceptibly significantly affect the reproduction of a man, or rather, spermatogenesis. This microflora is able to influence sperm from three sides at once: destroy spermatozoa, attach to the moving part of undestroyed spermatozoa, and also thicken sperm. This effect on sperm is more than enough to make a woman wonder if it is possible to get pregnant with ureaplasma from a partner. Having previously passed a course of treatment And when you become pregnant, it is better not to worry about the health of your baby.

During pregnancy, a woman is so vulnerable and susceptible to the negative influence of external factors that even the simplest and most easily curable diseases can turn into a real danger to her condition and the well-being of the child.

The fact is that any infectious and other kinds of diseases, as a rule, require intensive preventive measures or therapeutic therapy.

It will not be difficult for you to follow medical recommendations and forget about the problem. However, being pregnant, you will not be able to fully fight the disease, since any medications can have a very adverse effect on the development of the baby.

At the same time, the disease cannot be started either. Especially when it comes to such an infection as mycoplasma. These dangerous microorganisms can provoke a number of complications and lead to disastrous consequences.

Mycoplasmas are a type of single-celled microorganisms. They share features with bacteria, viruses, and fungal infections, but they can be placed somewhere in between.

With the external environment, mycoplasmas are separated by a membrane, since they do not have cell walls.

However, mycoplasmas are distinguished by their ability to grow outside of this environment. Their methods of reproduction are budding and fission.

There are some disagreements between physicians from different countries, which consist in what type of organisms to attribute mycoplasmas to: many consider them conditionally pathogenic, that is, such that they can make up the normal microflora of the vagina and become active only if certain favorable conditions are present. However, there are other opinions proving that the infection should be attributed to absolutely pathogenic organisms.

Very often, tests can detect mycoplasmas in perfectly healthy people who do not have any complaints. Doctors say it's entirely possible.

You can be a carrier of an infection for many years, and find out about it only when the immune system gives a serious failure.

Pregnancy is one of the factors that provokes the activation of mycoplasma and its harmful manifestations.

Varieties of the disease

Among the many types of mycoplasma infection that exist in nature, only a few of them pose a danger to the human body:

• Most often during pregnancy, women encounter Mycoplasma hominis and Mycoplasma genitalium.

These types of infection cause many urogenital diseases, contributing to the emergence of various inflammatory processes: acute endometritis, adnexitis. Often this microorganism is detected in tubal infertility;

• Much less common is Mycoplasma pneumonia, the microorganisms of which affect the organs of the genitourinary system, causing inflammatory diseases, pyelonephritis, urethritis, and respiratory diseases.

As a rule, the activity of mycoplasma is usually accompanied by the presence of other urogenital infections (Ureaplasma urealiticum and others).

During pregnancy, if a woman is a carrier of an infection, then microorganisms usually manifest themselves sharply, although before that the disease can proceed almost imperceptibly and even without symptoms.

Mycoplasmas are dangerous not only for women, but also for men: by affecting the urethra and foreskin, they often contribute to a decrease in sperm activity, and sometimes provoke their incapacity or death.

How does the infection enter the body?

Genital varieties of mycoplasmas are sexually transmitted.

Of course, sexually active people who are promiscuous are most likely to become infected.

Getting on the cells of the epithelium of the mucous membrane of the genitourinary tract, microorganisms grow into entire colonies.

Since mycoplasmas do not have the ability to function for a long time outside the human body, infection by household means is rare.

However, you should still be careful in matters of personal hygiene and not use the things of a possible carrier of the infection (we are talking about towels, underwear or bed linen, a swimsuit, etc.). Respiratory types of mycoplasmas are transmitted by airborne droplets.

A pregnant woman infected with mycoplasmas can transmit the disease to her baby.

Most often this occurs during childbirth, but intrauterine infections of the fetus also occur. This turn of events is fraught with many complications and disastrous consequences.

What danger does the disease carry: consequences for mother and child during pregnancy?

Then they certainly underwent a number of examinations and analyzes, among which were studies aimed at identifying such infections.

Therefore, doctors insist on preparing for bearing a child, because the detection of a problem before pregnancy is the key to successfully getting rid of it, without harming the baby.

Pregnancy weakens your immunity, causes various hormonal and other changes in the body, which allows hidden infections and chronic diseases to become more active and act intensively. But the whole difficulty lies in the fact that they pose a real threat specifically to pregnancy, without being so radically dangerous in general:

• many doctors claim that mycoplasmas provoke miscarriages (spontaneous abortions) or stop the development of the child ();
• in the later stages, the infection destroys the amniotic membranes, which often leads to or;
• with excessive activity of the disease, women may suffer from pathologies of the genitourinary system and other complications;
• intrauterine infection of a child is quite rare, however, in such cases, the fetus is faced with a total lesion of the main organs and systems (liver, kidneys, eyes, central nervous system, skin, lymph and tissues), which can lead to his death;
• most often, mycoplasmas adversely affect the child during passage through the birth canal.

The infection flares up in the baby's respiratory system, causing inflammation of the pharynx, nose, broncho-pulmonary tree. Other complications (congenital pneumonia, conjunctivitis, sepsis) may also occur. The genital organs are affected only in girls;

• in women, mycoplasmas cause inflammation of the vagina and urogenital organs, contribute to the development of various other chronic processes, which often leads to recurrent miscarriage and even infertility.

In addition, the infection provokes postpartum complications (like endometritis). For a baby, the main risk factor is a weak immune system. That is, if he is born prematurely or with a critically low body weight, then the disease will be very difficult, not giving in to treatment for a long time, manifesting itself again and again.

Main symptoms: how to recognize a dangerous infection?

Worst of all, in half of the cases of infection or disease with mycoplasmosis, the infection practically does not manifest itself.

The first symptoms may appear some time after infection (within a few weeks), but they are not much different from signs of other urogenital diseases:

• , rather moderate;
• burning, itching (genitals);
• painful or simply unpleasant sensations during urination and during sexual contact;
• when the uterus and its appendages are already subject to the inflammatory process, the woman may feel periodic.

Usually, these symptoms can be taken as manifestations of thrush and not given much importance to them.

Meanwhile, the infection will spread further, causing erosion, chronic urethritis, mucopurulent endocervicitis, endometritis and adhesions of the pelvic organs.

All these complications can gradually lead you to infertility.

How to diagnose a disease: what tests should be taken?

If you find an infection while pregnant, don't panic ahead of time. Complications, as a rule, arise only during its active phase.

However, it is necessary to constantly undergo examinations and take tests so that the doctor understands whether there is a threat to pregnancy and the child, and can also correct preventive or therapeutic therapy.

Diagnosing an infection is quite difficult. Since these organisms are an integral part of the natural human microflora, the detection of their presence in the analyzes is not yet a disease.

To understand if you have mycoplasmosis, you will need to determine how many microorganisms you have. To do this, there are several basic diagnostic methods.

Research using PCR

This method of molecular diagnostics can detect the presence of DNA of the infectious agent in a material sample (urogenital swab, urine, etc.). The principle of the study is based on the fact that the number of copies of a specific site (specifically for this pathogen) increases many times over.

This helps to distinguish exactly mycoplasmal infection from other similar ones (, gonorrhea,). The analysis will either confirm its presence, or give a negative result.

The PCR method is considered very effective and reliable, because it is able to detect even single cells of microorganisms. It is used when it is not possible to confirm the diagnosis with other types of diagnostics (often in chronic or asymptomatic diseases).

However, even the most insignificant factors can affect the result, for example, the rules for collecting, transporting and examining the material were violated, or the patient took some medications before the analysis, etc. In this case, false negative or false positive results are possible.

If the diagnosis showed the presence of an infection (Mycoplasma genitalium), the doctor will refer you for additional examinations.

Studies using bacteriological culture

For the cultivation of mycoplasmas, a special environment with suitable nutrients is created. This diagnostic method is also considered very accurate, because it can not only detect the presence of a specific infection, but also determine the number of harmful microorganisms.

In addition, with the help of sowing, the doctor determines whether mycoplasmas are sensitive to any specific antibiotics in order to select the appropriate treatment.

As the test material is used: urine, urogenital smear.

Mycoplasmas are classified as pathogenic organisms and treatment is prescribed only if their number in the analyzed material exceeds the norm of 10. Usually, it will take several days to receive the results of the study.

ELISA for the determination of microorganisms in the blood

An enzyme-linked immunosorbent assay (ELISA) is another effective test that can detect if your blood contains specific antibodies or antigens for that particular infection. According to its results, not only the presence of a problem is judged, but also the course of its development or progression, that is, at what stage the disease is.

This analysis is highly sensitive and can track the entire dynamics of the process (compare the amount of certain antibodies at different times, for example, during treatment).

The most common material for ELISA is the patient's blood. Also, swabs from the genital organs or samples of amniotic fluid can be taken for analysis (if there is a suspicion of intrauterine infection).

The doctor should explain to you how to properly prepare: take an analysis on an empty stomach, stop taking various medications and medications 2 weeks before the study, etc.

The result will be ready very quickly (within a day). If you are infected, then your body produces immunoglobulins of different classes: IgA, IgM and IgG. Their titers will indicate the duration of your infection, that is, the number of:

• if IgG and IgM are detected in the blood, doctors will consider the presence of an infection as a primary infection;
• if antibodies are present only in the isolated IgG class, then with a small titer it will be possible to speak of immunity to the disease, and with its manifested dynamics and increasing amount, chronic infection;
• if IgA is added to them, doctors state an exacerbation. The concentration of this class will directly depend on how pronounced the inflammatory process is.

Only a doctor can interpret the meaning of titers and decipher the analysis data.

• If the titers are below 0.9 c.u., this means that microorganisms have not been detected.
• With values ​​from 0.9 to 1.1 c.u. talking about a suspicious infection.
• In the case of the presence of antibodies above 1.1 - about the fact of infection.

However, as you remember, this does not mean at all that all complications will affect you, or that the disease will manifest itself at all.

The survey must be comprehensive. The doctor will refer you to both general tests and follow-up examinations to make sure the diagnosis is correct.

Possible treatment options

Since this type of microorganism is very resistant to external influences, it is difficult to control it, and treatment is usually extended over a long period of time.

The prescribed therapy must be taken together with the husband (partner), since the human body does not have stable immunity to this infection. That is, you will constantly be at risk of re-infection.

The treatment program is selected by the doctor individually, based on many factors and the state of your health.

• It will be necessary to take into account how comparable the risks from the consequences of the disease or the consequences of taking medications for a pregnant woman.

If mycoplasmas do not have a pathological effect on the child and mother, then the dynamics of microorganisms is simply observed. If specific complications appear, then appropriate therapy is prescribed (antibiotics - not earlier than the second trimester).

• The specialist should build on the results of all your analyzes and examinations in his conclusions.

The drug is prescribed according to the indications of the resistance of microorganisms, and its administration is adjusted in the process.

• In addition to antibiotics (during pregnancy, drugs from the macrolide group are prescribed, since they have short courses of administration and are relatively safe for the baby in relation to other drugs), the doctor will prescribe you medications to restore the intestinal microflora, as well as drugs that will help increase immunity (supplements, immunomodulatory drugs).

After the therapy, tests are repeated to determine whether it was effective.

In no case do not prescribe treatment for yourself, as you risk not only starting an infection, but also harming yourself or your baby.

Prevention

It is better to prevent any disease in time. This will save you from many complications and unwanted consequences. You should also follow the basic preventive measures:

• lead a healthy lifestyle (adhere to the daily routine, provide yourself with a complete and balanced diet, play sports, give up bad habits);
• harden and strengthen your immune system;
• do not engage in promiscuity, use contraceptives (barrier);
• regularly examined by a doctor;
• follow the rules of personal hygiene.

If you plan to conceive and give birth to a healthy child, then it is worthwhile to undergo the necessary examinations and tests in a timely manner. By planning and preparing for pregnancy, you can detect and fix the problem before it poses a threat to your health or to the well-being of the little person inside you.