Bacterial Vaginosis, or "BV", is a common vaginal infection caused by an overgrowth of bacteria. While it is usually not a serious condition, it can lead to a range of uncomfortable symptoms including itching, burning, and discharge.

BV can also have an impact on fertility. Recent research has shown that BV can disrupt the delicate balance of bacteria in the reproductive tract, leading to a range of complications that can make it more difficult to become pregnant. But don't panic just yet — in this article, we'll explore the link between Bacterial Vaginosis and fertility and arm you with the information you need to seek treatment before it's too late. 

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What Is Bacterial Vaginosis?

The vaginal microbiome is a complex ecosystem of microorganisms, including bacteria, fungi, and viruses that inhabit the vagina. Crazy, right?

Lactobacilli is the dominant bacterial species found in a healthy vaginal microbiome, and it helps maintain an acidic environment, which protects against infection by harmful bacteria such as Gardnerella vaginalis.

When the balance of bacteria in the vagina is disrupted — often caused by changes in the acidity or pH levels — Bacterial Vaginosis can occur, causing symptoms like abnormal discharge, itching, and an unpleasant odor 'down there.'  

The pH levels of your vagina can be pushed in the wrong direction through vaginal douching, frequent intercourse, new or multiple sex partners, and hormone changes. These changes can include menstruating, pregnancy, menopause, and even hormonal birth control, according to Planned Parenthood. 

While BV can be caused by changing acidity in the vagina, it is not a sexually transmitted infection, and you can develop BV even if you aren’t sexually active.  

What Are the Symptoms of BV?

According to the CDC, 84% of women who have Bacterial Vaginosis don’t experience any symptoms. 

Women who do show symptoms may experience the following:

  • Gray or white discharge that smells fishy (it literally reeks like tuna)

  • Vaginal irritation and itching

  • Burning when you urinate (this painful showdown is also called dysuria)

BV is not the same as a yeast infection, which is caused by an overgrowth of a fungus called Candida. A yeast infection doesn’t have an odor and the discharge is thicker, more like cottage cheese. It’s treated with antifungals, whereas BV is treated with antibiotics.

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Can Bacterial Vaginosis Affect Fertility?

Research shows that BV doesn’t affect conception. Well, not directly anyway. Instead, BV can cause damage that can potentially cause other problems.

Studies revealed that women who are undergoing fertility treatments were more than three times as likely to have BV than women who conceived naturally. This link is particularly strong with women experiencing tubal infertility due to scarring, tissue damage, or infection of their fallopian tubes. Tubal infertility can be caused by pelvic inflammatory disease (PID), and untreated BV raises the risk of getting PID.

BV can also cause inflammation of the cervix, which can affect the quality of cervical mucus. Cervical mucus plays an important role in fertility by helping sperm travel through the cervix and into the uterus. When cervical mucus is affected by BV, it may not be able to effectively transport sperm, which can decrease the chances of conception. 

In addition, BV increases your chances of getting sexually transmitted infections (STIs) such as chlamydia and gonorrhea. These STIs are known precursors of infertility. So while BV may not cause infertility on its own, it shows up as a guilty accomplice to other risks. Researchers say that this is because microbes travel from the vagina up to the cervix, uterus, and fallopian tubes, spreading infection. 

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BV During Pregnancy

Unfortunately, during pregnancy is when BV can get nasty. An untreated infection doubles the chance of having a miscarriage in the first trimester if you went through IVF, according to studies

BV also raises the risk of premature birth, and babies are often born underweight. In addition, PID and endometritis (both a higher risk with BV infection) are connected to ectopic pregnancies, tubo-ovarian abscesses, and chronic pain.  

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How Is BV Treated?

The main thing to remember is that you need to break the cycle of infection. It doesn’t help to just get a course of antibiotics from your doctor. You should also try and prevent a future recurrence.

According to Planned Parenthood, after taking the prescribed antibiotics, avoid any sexual activity until the BV has cleared up. If you have a female sexual partner, make sure she is tested for BV as well. It also helps to avoid irritating soaps and douching and to supplement with probiotics. The latter is essential for restoring bacterial equilibrium after taking antibiotics, as they eliminate the good bacteria, too.

Bacterial Vaginosis won’t necessarily keep you from getting pregnant, but it still has the potential to cause quite a bit of havoc. The symptoms are pretty unpleasant, and BV can pose some serious risks to your pregnancy. The good news is that this sneaky, smelly intruder is easily treatable with a course of antibiotics, which is why it's important to speak with your healthcare provider if you think you may have BV. 

​​Michelle Meyer is a freelance medical writer. She is busy completing an MSc in Physiology and Pharmacology and has been in the health and wellness industry for nearly two decades. Her interests include women’s health, mood disorders, and oncology.