Ureaplasma: The treatable infection that the fertility industry doesn’t want you to know about

Ureaplasma is not something I had ever heard about, until I chanced upon it from a visit to an acupuncturist. My husband and I had been trying to conceive for 2.5 years (that’s 30 months, or 884 days, and lets not even go there in hours…), and despite numerous doctors appointments along the way, and the acknowledgement that we were dealing with male factor infertility, there was not one mention of this infection and the effect it can have have on infertility.

My decision to visit an acupuncturist came from gearing up to our IVF with ICSI treatment that had been recommended by fertility doctors we had been sent to. I had undergone rigorous testing, all via the NHS; blood tests (numerous), ultra sounds, HSG, examination, hysteroscopy, laparoscopy, fibroid investigation, etc… Of the back of all this testing, I had treatment for mild endometriosis, but otherwise (and as the initial two blood tests had shown) my reproductive organs were in good working order, my hormones were doing their thing and I had a good Ovarian reserve. My husband on the other hand had two semen analyses, both of which showed we had a significant motility issue (5%/8% vs the ‘normal’ >40%), amongst a few other marginally sub-optimal parameters. 2 sperm analyses was all the testing he had.

The conclusion was drawn; IVF with ICSI was the only viable option available to us.

Great. It felt like after a long wait there was an answer to our struggle. In the gear up to our first IVF appointment, and having googled the sh*t out how we might be able to improve our chances of success with our 1 NHS funded IVF cycle, I came across acupuncture which is how I met the lovely and super-knowledgeable Justine Hankin.

Justine was regailed with our history, and gave us some advice and information. Its safe to say that the stop drinking advice went down like a lead balloon with my husband — particularly seeing as the doctors we had seen had dismissed it being a contributing factor. Did you know that you are 8 times more likely to conceive if your partner abstains from drinking in the week before conception? Anyway, I digress.

One of the nuggets of information she shared was the existance of an infection called Ureaplasma which can severely impact fertility, and that we should seriously consider undergoing some tests, because not only can it affect chances of natural conception, but it can also reduce chances of IVF success. Unfortunately this is not a test that the NHS can conduct, so we would have to arrange these tests privately.

Now, if you chose to google Ureaplasma, you would find articles suggesting it may play a part in infertility, by effecting the sperm quality in men and increasing the chance of miscarriage in women, but the overwhelming verdict you would reach (as a layman) is that there is not much conclusive research and in fact it appears to be pretty hard to treat. I will get on to this later, but the online evidence leaves you feeling that it is quite the leap of faith to spend several hundred pounds on private appointments and testing, when 1) you might not even have the infection 2) there is no conclusive evidence it effects fertility 3) its hard to treat even if you do have it.

Its safe to say my husband was sceptical, who was this lady who sticks needles in people, to give us advice that knowledgeable medical doctors had not even mentioned? It took some convincing, but he finally agreed to the testing.

Low and behold, the ureaplasma infection was found in both of us (it is sexually transmitted, so this was hardly surprising).

Referrals finally lead us to Mr Jonathan Ramsey, a medical doctor and widely acclaimed urologist. He not only advocated the Ureaplasma infection as a significant contributing cause of sperm quality and male infertility, but also shared his ambition to educate as many fertility doctors and GPs as he can to this effect. He also commented that he was in the process of conducting an NHS research study, in the hope of discovering conclusive evidence to this end.

In fact, while sperm quality is an area with which the infection is closely linked, there are other areas of infertility that is has also been linked to. Investigations into recurrent pregnancy loss found Mycoplasma hominis and Ureaplasma urealyticum to be one of 3 major causes of miscarriage. Some evidence suggests that the presence of Ureaplasma Urealyticum in conjunction with some other bacteria can lead to Bacteria Vaginalis which has been linked to causing endometriosis — yet another condition that can reduce fertility.

Mycoplasma hominid (onother microplasma bacteria) and Ureaplasma urealyticum may be found in the cervix (40% — 80%) or in the vagina (21% — 53%) of women.

In terms of treatment, there is an 80% chance of anti-biotics treating the infection (far greater than the chances my googling had suggested).

The big question is that if all of this is so, why do we not know more about it and have more conclusive research?

The challenge here is that there is also no appetite for private funded research in this field, and government funding is finate and spread over so many areas of medicine. To be completely cynical about the lack of funding in the private sector, the infection can lead to reduced chances of IVF success, and with a failed IVF comes another IVF attempt. There is no incentive for big business fertility clinics to conduct research into something that is going reduce the amount of business coming through their doors, and so it continues to slip under the radar.

I feel quite passionate about getting the message out there. With every cycle of IVF costing in the region of £5,000, and with CCGs across the country cutting IVF funding for lack of funds, you can’t help but feel that introducing a test that costs less than £200 to complete, and for which simple anti-biotic treatment could avoid costly IVF and result in natural conception, something needs to be done to include it within routine infertility testing.

I am currently half way through my 3 week antibiotic course, and I can’t help but feel the increased hope this brings us. While there are other areas of treatment we are still to undergo, I will continue to share our journey, and hope that we will get to a positive outcome at the end.