Is Ureaplasma associated with infertility and miscarriage?
What is Ureaplasma?
Ureaplasma is a type of bacteria that naturally lives in the urinary and genital tracts of both women and men. It can be passed through sexual activity, but it is not always considered a sexually transmitted infection (STI) as it can also be found in people with healthy reproductive systems. It is surprisingly common, with research showing infection rates as high as 40–80% in women and up to 50% in men. Because Ureaplasma does not have a cell wall, it is naturally resistant to many antibiotics, which can make treatment more challenging when needed.
The Link Between Ureaplasma and Fertility
Research has established that Ureaplasma can contribute to several challenges for reproductive health and significantly impact fertility outcomes. Not everyone with Ureaplasma will experience these outcomes, however it is an important consideration for couples with infertility or recurrent pregnancy loss.
In women, Ureaplasma has been linked to:
Pelvic inflammatory disease (PID), which can cause scarring, adhesions, and blocked fallopian tubes through chronic inflammation.
Disruption of the immune environment in the reproductive tract, making fertilisation, implantation, and early pregnancy maintenance more difficult.
Adverse pregnancy outcomes such as miscarriage, preterm birth, premature rupture of membranes, and stillbirth, potentially due to endometrial inflammation and immune dysregulation.
Chorioamnionitis (infection of the placenta and amniotic fluid) whereby Ureaplasma bacteria travel upwards through the cervix and into the amniotic cavity.
Reduced pregnancy rates and increased miscarriage risk in some women undergoing IVF.
In men, Ureaplasma has been linked to:
Reduced sperm quality and motility caused by oxidative stress, altered semen pH, and changes in seminal fluid composition.
Increased inflammation leading to DNA damage and lower levels of sperm proteins (such as P34H) and enzymes (such as hyaluronidase) needed for the sperm to bind to and penetrate the egg.
Higher levels of reactive oxygen species in semen, which can reduce the number of healthy, normal shaped sperm.
Testing for Ureaplasma
A standard vaginal swab from a GP does not usually test for Ureaplasma. Vaginal microbiome testing (VMT) provides a more detailed picture of overall vaginal flora, pH balance, and the presence of opportunistic species such as Ureaplasma. If you have symptoms such as unusual discharge, irritation, abnormal odour, painful intercourse, or ongoing fertility challenges, assessing your vaginal microbiome can provide valuable insight. A naturopath can arrange VMT and create a targeted plan to help clear Ureaplasma where indicated. As Ureaplasma can be passed between partners, it is important that both male and female partners are tested and treated if necessary to prevent reinfection.
Naturopathic Support
As naturopaths, we utilise a holistic approach and can support you in eliminating unwanted vaginal symptoms and optimising fertility by helping to restore a healthy vaginal environment, rebalance vaginal pH, and address underlying contributors such as poor immune function, chronic inflammation, or hormonal imbalances.
Treatments may include herbal medicine, oral or intravaginal probiotics, topical or intravaginal creams and rinses, dietary and lifestyle adjustments, and education around sexual hygiene. The potential impact of Ureaplasma on fertility and overall reproductive health highlights the importance of comprehensive testing for couples facing infertility or recurrent pregnancy loss. For women, this may involve VMT, while for men it may include a urinalysis to check for Ureaplasma and other infections. Identifying and treating any underlying infections may be a crucial step toward optimising reproductive health, improving fertility outcomes, and giving you the best chance of a healthy pregnancy.
You can read more about vaginal microbiome testing here.