Can chlamydia cause infertility? I just tested positive for it, and now I am really worried about my ability to have kids.
—Anonymous
Unfortunately, chlamydia can cause infertility as it can affect the fallopian tubes. One benefit of being tested if you are sexually active is being able to identify and treat chlamydia. Many people with chlamydia will have no symptoms, but some will end up with a condition called pelvic inflammatory disease (PID). In both cases (whether you have symptoms or not), we know that there is the potential for fallopian tubes to be damaged by the infection, meaning the tubes become blocked and do not function normally. The sperm fertilizes the egg in the fallopian tube, so if the tube is blocked or damaged, it can lead to infertility and/or an increased risk of an ectopic pregnancy.

Prompt treatment of chlamydia minimizes the chance of damage to the fallopian tubes. Thus, not everyone who gets chlamydia will always end up with tubal disease. A prospective study of 194 patients with tubal factor infertility found that one in four of those patients had positive antibodies to chlamydia, which indicates a past infection. Epidemiologic and longitudinal cohort studies have shown that chlamydia infection does increase the risk of tubal factor infertility, but that the overall incidence of long-term sequelae is low. Quantifying the effect of chlamydia infection on tubal factor infertility is difficult, as a past infection cannot always be reliably tested for, and the time course between an infection and then going to a fertility clinic could be many years apart.
The upshot: we do know that chlamydia can damage fallopian tubes and impact your fertility, particularly if untreated. However, we also know that not everyone who gets chlamydia becomes infertile from damaged fallopian tubes and, conversely, not everyone with tubal factor infertility has had chlamydia. The good news for you is that you have been tested and can be treated, which can hopefully prevent any sequelae to your reproductive health.
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