Most reproductive endocrinologists routinely obtain samples from the cervix (cervical cultures) to assess their patients for gonorrhea, chlamydia, ureaplasma, mycoplasma, and other bacterial infections. Gonorrhea and chlamydia are sexually-transmitted diseases that can cause tubal damage and infertility when these bacteria travel from the cervix through the uterus and out into the fallopian tubes. Sexually-transmitted infections can be passed back and forth between sexually intimate partners. Patients with gonorrhea may have a yellowish discharge associated with pelvic pain and fever. Although chlamydia can be associated with these symptoms, chlamydial infections are often silent. Despite their lack of symptoms, chlamydia infections may result in significant tubal scarring and damage.
Ureaplasma and mycoplasma are bacteria that can be commonly found in the reproductive tract of both men and women. It is somewhat more problematic to label these two bacteria as reproductive tract pathogens because they are often found in fertile, healthy couples in addition to those with infertility. Although the presence of these two bacteria has been hypothesized to play a role in both infertility and miscarriage, the specific mechanisms by which they impair fertility remains unclear. The question of whether ureaplasma or mycoplasma can cause reproductive tract damage or whether their presence increases the rate of miscarriage has not been definitively answered. As a consequence, many clinics do not test for ureaplasma or mycoplasma routinely.
If cervical cultures for ureaplasma and mycoplasma are positive, both the patient and her sexual partner are usually treated with antibiotics such as doxycycline. As these bacteria may have been present for many years without causing any symptoms, the finding of ureaplasma and mycoplasma on cervical cultures does not in any way indicate infidelity or sexual misconduct.
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