Can I just start by saying once again thank you for all your help in the past, I trust you with all my sexual health questions and I turn to you for help again. 

You recently helped me with worries from some recent missteps that happened in 2020 and because of that I’m clear that I didn’t have any infections from them. 

My question now going forward concerns infections that acquired a long time ago. So me and my wife are struggling to conceive - she is also getting some fairly odd none specific symptoms mainly periods that are either late or early. (This is recent maybe been going on 9 month now). 

as you can imagine this has concerned me especially with STDs having an effect on fertility. 

I’m happy to say that I have been for sperm analysis and she had blood tests and all are ok with them. We can’t have further tests as she has already had a child and as such not eligible on the NHS.

Anyway with my STD concerns - until my recent missteps in 2020 I have NEVER had an STI screen (bad I know) so now I’m worried about all the other exposures I have had in the past! And if they now present a risk. My wife has never once had a screen, and dosnt know about any of my missteps. 

About 2.5 - 3 years ago I received while drunk a blowjob.

About 8 years ago another blowjob received 

And 14 years ago another blowjob

My entire sexual history is blowjobs and sex with my wife regular partner. 

So questions are,

1) So I read on here about spontaneous resolution of infections namely chlamydia. Could I have feesably caught chlamydia or any infections Ghon? from any and all of my encounters and cleared it myself? Thus my wife is living with Clymidia and now causing us to have fertility problems

2) in regards to spontaneous resolution is that mainly for people not re-exposed or can two people living with clymidia regularly have sex and still resolve or would we keep reinfecting each other? 

3) do I need to mention these events to my wife in order to get her STI screened. Obviously if she 

1.  You are correct, chlamydial and gonococcal infections both can resolve spontaneously. It would be unheard of however for you and your wife to be passing STIs back-and-forth over a period of years and being unaware of it. Further as I’ve already mentioned, it is more likely than not that your wife has already been tested for STDs.

2.  See above.

3.  At this point the only value I see of you mentioning your missteps to your wife might be the possibility of addressing your continuing guilt. I am confident that you were missteps are not the basis for your challenges in conceiving.

I hope my comments are reassuring. I know how important conceiving can be and how frustrating it can be when conception does not occur despite continuing efforts. I also understand how you might be thinking and rethinking whether you have contributed to these problems. Nothing you have communicated in this or your prior interactions with both Dr. Handsfield and myself however suggest that is the case. EWH 

It’s not necessary the fact that we will be passing back and forth I understand this is unlikely as I have tested 3 times in 2021 over the course of three months, . As well as other none specific urine tests, I imagine if I was going to get reinfected I would have by the 3 month mark. I’m more worried that I have successfully cleared an infection on my own, but she has not.  I wish I’d have been way more proactive in testing but here we are.

1) Is it feesable that I have spontaneously resolved an infection 2 years ago (for example) say chlamydia and she has not?  My whole brain is saying this isn’t possible but I’m no doctor?

2) I’m fairly sure she has not been tested for STI the only thing they did was a blood test. No swab of any parts. I have asked?

3) can you give me your thoughts on chlamydia via receipt of oral sex. You have told me before it’s negligible risk and I have seen you and Dr HHH say little to no risk and even recently saying almost zero risk. Yet CDC, NHS and other professional bodys says it’s a risk. I understand even if it’s a 1% it’s still a risk so they would have to say as much but it really reads as it’s a bigger risk than you and Dr HhH say? Or am I putting words in your mouth (anxious people can read what they want to)?

Or even am I reading old posts and the recent science has changed? I don’t get how it works if I’m honest. 

4) We have lost a baby too about 2 year ago - I think this is when I started on the anxiety and depression route. I’m going to guess that this doesn't change your evaluation of the whole situation but while I’m sat crying typing this - could I have caused this. She lost it fairly early in the cycle I wish I could remember exactly but let’s say 12 week. 

1. No

2. I'm surprised she has not had testing.  She would have had a pelvic examination and testing early in the course of an infertility evaluation in the US

3.  Oropharyngeal chlamydial infections occur but very rarely- in about 1% of at risk sexually active persons compared to over 5% of the same population having gonorrhea.  These infections tend to be self limited and are poorly transmissible.  The CDC and NHS tend to be conservative in their assessments, working to "never be wrong".  

4.  I'm sorry for your loss.  As you point out however, this in no way changes my assessment or advice.

Please try to stop beating yourself up on this.  EWH

I think i have got my head around it all now.

but just if i can some final follow ups.

1) can you clarify on why its not possible for me to have cleared and stayed cleared but my wife persist? is this because i would reinfect myself if her infection persists.

2) she has never had a STI test or pelvic examination - a nurse took her blood is all and the doctor called a week later and said "everything normal" - this worries me a bit as you clearly think a STI test and examination is worth it? is that just par for the course or am I somewhat at risk?

3) can you in a word or two some up the risk that my wife has a STI (based on what I told you all true, and assuming shes had no extra marital affairs) is it "NO RISK" or "VERY SMALL CHANCE" ie have i done enough at my end to protect her.

4) can you just confirm I'm on the right track on my risk thinking. Oral sex receiving is low risk, Ghonnaria would have been obvious in me. Chlamydia is rarely present in the throat and when so clears quickly and not easy transmittable so the risk of me getting Chlamydia from the offset is slim to none?. Following on from this even with the bodies self clearing of Chlamydia, if me and my wife infected we would more than likely ping pong between ourselves ie not successfully clearing the infection so even in the unlikely event we both stayed asymptomatic when i finally came to my senses and tested myself for STI  in Jan, Feb and April 2021 I would most likely have been positive if my wife was living with it? So the way i see it absolutely NO CHANCE that my wife has chlamydia but i notice you have stopped short of saying that in our conversations.

5) am i missing anything that presents a risk no matter how minute - any feesable way she could be infected (i know you probably wont want to say to fuel my anxiety but please no matter how far fetched is it possible my wife has Chlamydia, from me)

6) In regards to infertility caused by STI is this the case if it progressed to PID ? or can chlamydia cause infertility if its uncomplicated. 

1.  Correct, you would’ve been reinfected.

2.  I don’t know your wife’s age but for her to not have had a gynecologic examination which would evaluate her not only for STI‘s but for cervical cancer is would be most unusual here in the United States. I cannot comment on whether this is usual practice in the UK or not.  Further, for an OB/GYN to carry out and infertility evaluation without examining the patient also strikes me as unusual.

3.  Her risk I’m having been infected by you and being infertile because of that is virtually zero

4.  Correct 

5.  From all you said there is virtually zero chance that your wife has chlamydia or that you have infected her with chlamydia of course I cannot say no risk not knowing anything of her past history. Further in medicine and science we can never say never. I would presume her risk of having acquired chlamydia through the mechanism that you hypothesize it’s about the same as your risk of being struck by a meteorite falling from space.

6.  Uncomplicated chlamydia, by definition, does not cause PID or infertility

7.  Rarely

8.  Not necessarily

My responses are based on my my practice and research devoted to the topic of sexually transmitted infections for more than 40 years. I write textbook chapters and have written over 300 peer reviewed manuscripts on sexually transmitted infections. You really need to MoveOn. The more I look at your post, the more it occurs to me that you would benefit from counseling. End of thread. EWH