Female genital urinary schistosomiasis: Is there an association with infertility

Several authors have reported genital tract involvement in urinary schistosome infection, resulting in local lesions. Pathological changes in the lower and upper genital tract may affect couple sexuality and lead to infertility. Upon informed consent, 123 female subjects responded to a questionnaire related to infertility and history of urinary schistosome infection. A gynecological examination was carried out to assess lower and upper reproductive tract pathologies. Each participant submitted a urine sample for assessment of current urinary schistosome infection.

Almost half of the women examined had signs of primary (21%) or secondary infertility (28%). Similarly, almost half of the urine samples collected (44.8%) were positive for microhematuria. The prevalence of infertility was significantly higher among women with microhematuria or a history of hematuria (χ2=5.42, p=0.06). Women married more than once were 2.64 times more likely to report a history of hematuria than those married only once (p=0.06). Individuals who reported dyspareunia were 2.63 times more likely to report a history of hematuria (p=0.004). There was an association between hematuria, history of hematuria, female genital schistosomiasis and infertility. An in depth assessment of the causal relationship between urinary schistosomiasis and infertility is warranted.