Ureaplasma and Infertility: Causes, Testing, and Treatment

Trying to conceive can sometimes feel daunting, especially when you're searching for answers. One surprising aspect of fertility testing involves microbes like Ureaplasma, a tiny bacterium that lives in the genital tract and often goes unnoticed. Some studies suggest that Ureaplasma may play a role in fertility challenges for both men and women, but the scientific community hasn’t reached a clear consensus yet.

Because Ureaplasma isn’t routinely included in standard sexually transmitted infection (STI) or fertility tests, it’s often overlooked. When left undetected, it may contribute to inflammation or other subtle changes in the reproductive tract that could affect conception.

Let’s take a closer look at what the current research says about Ureaplasma and infertility — exploring the evidence, testing options, and treatment approaches to help you make informed decisions about your reproductive health.

How Ureaplasma is linked to infertility

Ureaplasma is a type of bacteria that belongs to a group called "genital mycoplasmas," which are a bit unusual because they don’t have a cell wall. This can make them harder to detect and treat compared to other bacteria. While Ureaplasma can peacefully coexist in the genital tract of many people, it can sometimes cause problems by triggering inflammation or affecting reproductive health.

In women, Ureaplasma can settle in the cervix, uterus, and even the fallopian tubes. If it moves to the upper reproductive tract, it might cause inflammation in the endometrium (the lining of the uterus), which can make it more challenging for a fertilized egg to attach and grow. Ongoing inflammation in the uterus has been linked to issues like repeated implantation failures, adverse pregnancy outcomes such as early miscarriages, and unexplained infertility.

For men, Ureaplasma infection has been connected to changes in sperm motility and lower sperm quality, potentially due to oxidative stress and inflammation in the seminal fluid.

One thing to keep in mind is that Ureaplasma infections often don’t show any symptoms and aren’t typically included in standard STI tests, so they can easily be overlooked — even during fertility assessments. Testing for Ureaplasma might be a helpful step for couples or individuals facing unexplained difficulties in conceiving.

Why Ureaplasma is often overlooked in fertility testing

Most standard STI or fertility tests focus on pathogens like Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis. Ureaplasma and its close relative, Mycoplasma hominis, aren’t automatically included because they’re common colonizers and can exist without symptoms. Many clinics only test for them if there are specific signs of infection (such as persistent discharge or pelvic pain) and all other infections have been ruled out.

Additionally, Ureaplasma requires specialized testing — often PCR (polymerase chain reaction) — to accurately identify its DNA. Because this testing isn’t routine, many people go years without knowing they carry it.

How untreated infections may affect reproductive outcomes

When Ureaplasma infection goes untreated, it can lead to chronic inflammation of the reproductive tract. This inflammation may interfere with the quality of cervical mucus, embryo implantation, or even sperm–egg interaction.

In women, Ureaplasma has been detected in some cases of pelvic inflammatory disease (PID), chronic endometritis, and tubal factor infertility, though the evidence for a direct connection remains limited and sometimes inconsistent. Most research suggests that Ureaplasma alone is unlikely to cause these conditions, but it may contribute alongside other microbes or in the context of broader vaginal microbiome imbalances that affect reproductive health.

In men, Ureaplasma can colonize the urethra and prostate, potentially decreasing sperm count, motility, and DNA integrity. If both partners are infected, reinfection can occur even after treatment, further complicating conception efforts.

What scientific evidence says about Ureaplasma and infertility

The scientific link between Ureaplasma and infertility has been explored for decades, but findings vary. Meta-analyses and large cross-sectional studies consistently show that Ureaplasma species (especially Ureaplasma urealyticum and Ureaplasma parvum) are more common in women with infertility compared to fertile controls. However, not every study agrees on the strength of this association.

One reason the research on Ureaplasma and infertility seems so mixed is that Ureaplasma often doesn’t act alone. In many cases, it appears alongside other bacteria that can also disrupt the vaginal or reproductive environment. Scientists describe Ureaplasma as an “indicator species”, which means its presence can signal that other, less healthy microbes are thriving too.

Because of this, it’s difficult for researchers to prove that Ureaplasma is the sole cause of infertility. Instead, the broader imbalance in the vaginal microbiome — including other anaerobic bacteria or pathogens that flourish in the same environment — may be contributing to the problem.

So, when studies link Ureaplasma to inflammation or implantation difficulties, it’s important to remember that these effects could also stem from the company it keeps. Understanding your complete microbiome, rather than focusing on a single bacterium, gives a more accurate picture of what’s happening in your reproductive tract.

That’s why comprehensive tests like Evvy’s Vaginal Health Test are so valuable: they help reveal the full ecosystem of microbes, showing not only whether Ureaplasma is present, but also which other bacteria might be influencing fertility and overall vaginal health.

Effects on female fertility

Research suggests that Ureaplasma infection may impact fertility through inflammation and disruption of epithelial (lining) cells in the uterus and fallopian tubes. It can also affect vaginal microbiome balance, creating an environment less favorable for conception.

Studies have found Ureaplasma DNA in the lining of the uterus and in follicular fluid, which means it can move beyond the cervix and reach important reproductive organs. Some studies have reported that a higher number of infertile women have Ureaplasma urealyticum, while others did not find a clear connection.

Infections that occur together, especially with Mycoplasma hominis, can raise the risk of infertility. This likely happens because they cause increased inflammation.

Effects on male fertility

In men, Ureaplasma infection has been linked to male infertility, too. It can lower sperm motility (movement), lead to more abnormal sperm shapes, and cause DNA damage. The bacteria may stick to the sperm, changing how they work and how long they last.

Studies show that men with Ureaplasma infections often have lower sperm counts or poorer sperm motility. While not every case of Ureaplasma causes infertility, higher levels of bacteria are associated with worse semen quality.

Why research findings differ

Differences among studies may reflect variations in testing methods, sample size, or the species of Ureaplasma examined. Some researchers also point out that colonization (harmless presence) and infection (pathogenic presence) aren’t the same. High bacterial load, specific types of Ureaplasma, and co-infection with other microbes may be the real drivers of infertility risk.

Overall, while causality isn’t fully established, the current consensus supports screening for Ureaplasma during infertility workups, especially in cases of unexplained infertility.

Symptoms of Ureaplasma infection that may affect fertility

Although Ureaplasma infection is often asymptomatic, some people may notice subtle signs. These can be easy to overlook or mistaken for other conditions. Signs that may appear include:

• Unusual vaginal discharge
• Pelvic or lower abdominal pain
• Pain during sex
• A burning sensation when you pee
• Recurrent urinary tract infections (UTIs)
• Vaginal irritation or discomfort
• Difficulty conceiving despite regular cycles and unprotected sex.

Because so many infections are asymptomatic, Ureaplasma is frequently found only during targeted testing, often after repeated fertility challenges.

How to test for Ureaplasma when facing infertility

If you’ve been trying to conceive for six to 12 months without success, or you’ve experienced recurrent pregnancy loss, it’s worth discussing Ureaplasma testing with your healthcare provider. Detecting and treating this bacterium can help identify a potential hidden barrier to fertility.

Emerging research has found that the vaginal microbiome (the community of bacteria and other microorganisms that live in the vagina) may play an important role in fertility and pregnancy outcomes. An imbalanced microbiome, especially one disrupted by organisms like Ureaplasma or Mycoplasma, may contribute to inflammation, poor implantation, or early pregnancy loss.

That’s why understanding your microbiome can be such a powerful part of a fertility evaluation. Evvy’s Vaginal Health Test not only screens for Ureaplasma and Mycoplasma using advanced metagenomic sequencing, but also provides personalized Fertility Insights based on your microbiome profile. These insights help you and your healthcare provider see how your vaginal environment compares to what’s typically associated with optimal fertility, and offer tailored recommendations for next steps.

Evvy’s at-home Ureaplasma & Mycoplasma test

Evvy offers a simple, discreet, and clinically validated way to test for Ureaplasma from home. The Evvy Vaginal Health Test uses advanced PCR technology to detect both Ureaplasma and Mycoplasma species with high accuracy. Here’s how it works:

1. Order your test online. Your discreet testing kit arrives at your door.
2. Collect your sample at home. Use the provided vaginal swab to collect a small sample in minutes.
3. Send it to the lab. Drop your prepaid sample in the mail. 
4. Get results within days. Evvy’s CLIA, CLEP, and CAP-certified partner lab analyzes your sample using PCR for precise detection.
5. Receive expert guidance. After a clinician reviews your results, you’ll receive a detailed report explaining your results and, if positive, clinical guidance for next steps, including when to seek medical treatment.

Clinical testing options

If you want to get tested in a clinic, talk to your healthcare provider about PCR or culture-based tests for genital Mycoplasma. They can take samples from your cervix, urethra, or semen, depending on who is being tested. Since Ureaplasma grows slowly and needs special conditions to be cultured, PCR is a better method for quick and accurate results.

How is Ureaplasma treated for infertility?

Once Ureaplasma is detected, targeted antibiotics are usually recommended, especially when infertility, pelvic inflammation, or other reproductive symptoms are present.

Standard antibiotic therapies

Doxycycline is the main treatment for Ureaplasma infections, and most strains respond well to it. The usual dose is 100 mg taken by mouth twice a day for seven days.

If doxycycline isn’t tolerated, macrolides like azithromycin (either a single 1 g dose or 500 mg daily for three to five days), josamycin, or erythromycin can be good alternatives. Research shows that azithromycin works as well as doxycycline for Ureaplasma urealyticum.

Treating partners and preventing reinfection

Because Ureaplasma can be transmitted sexually, treating both partners at the same time is critical to prevent reinfection. During treatment, it’s recommended to abstain from sexual activity or use condoms until both partners test negative.

Supportive care and retesting after treatment

After finishing your antibiotics, it's often a good idea to schedule a follow-up test, usually around three to four weeks later, to make sure the infection is fully cleared up. Taking care of your vaginal microbiome by incorporating probiotics and focusing on your overall health can also help keep infections at bay.

While antibiotics do a great job of eliminating infections, researchers are still exploring how this affects fertility outcomes. However, getting rid of chronic infections can definitely help reduce inflammation and create a healthier environment for reproduction.

Ureaplasma infertility outcomes

The question many people ask is: If I had Ureaplasma, can I still have children? The answer is generally yes, especially with early detection and treatment.

Natural conception after treatment

In many cases, people who test positive and complete antibiotic treatment can conceive naturally afterward. Eliminating the infection helps restore normal reproductive tract function, reduce inflammation, and support implantation.

While not every study shows a guaranteed improvement in fertility after treatment, many fertility specialists include Ureaplasma screening and management as part of an unexplained infertility workup.

Assisted reproductive technology outcomes

For those pursuing assisted reproductive technologies like intrauterine insemination (IUI) or in vitro fertilization (IVF), untreated Ureaplasma can affect success rates.  

Treating Ureaplasma before these procedures can optimize uterine health and sperm quality, potentially improving the chances of a successful pregnancy.

Fertility evaluation after infection clears

Once the infection has cleared, healthcare providers may recommend follow-up fertility assessments to ensure that no long-term effects remain. This can include checking fallopian tube patency, endometrial health, and semen parameters.

While antibiotic treatment may not guarantee conception, it removes one potential barrier, helping couples and individuals move forward with greater clarity.

FAQs about Ureaplasma and infertility

Will you be able to have kids if you had Ureaplasma?

Yes. Most people who have had Ureaplasma infections can go on to conceive naturally or with fertility treatments. Once treated and cleared, the infection usually doesn’t cause permanent infertility unless there has been significant damage to reproductive organs.

Can you be pregnant with Ureaplasma?

Yes, but it’s not ideal. Ureaplasma during pregnancy has been linked to complications like preterm birth. If detected during pregnancy, your doctor may recommend antibiotics to reduce risks.

Can Mycoplasma make you infertile?

Not necessarily. Mycoplasma hominis and Mycoplasma genitalium are types of bacteria that can sometimes show up in the reproductive tract. Some research suggests there might be a connection between these infections and difficulties with fertility, especially when they occur with Ureaplasma or other germs. However, they aren’t seen as a direct or guaranteed cause of infertility. Many people who have had Mycoplasma infections in the past can conceive without any trouble at all. The main concern is when active or untreated infections lead to inflammation or disrupt the reproductive environment, which can make it a bit harder to conceive. The good news is that treating these infections and taking care of any inflammation can help get everything back on track for a healthy reproductive system and better fertility outcomes.

Does STD testing include Ureaplasma?

Often, no. Routine STD panels typically screen for common reproductive tract infections like chlamydia, gonorrhea, and trichomoniasis, but not Ureaplasma infections. Detecting Ureaplasma requires molecular testing, such as PCR or other advanced methods that look for bacterial DNA. Evvy’s Vaginal Health Test goes beyond a standard STI screen. It uses metagenomic sequencing, a next-generation DNA technology that can identify and quantify all bacteria, fungi, and other microorganisms living in the vaginal microbiome — including Ureaplasma and Mycoplasma species. This means you’ll see not just whether Ureaplasma is present, but also how your overall microbiome balance compares to what’s typically associated with optimal vaginal and reproductive health. In addition to Ureaplasma and Mycoplasma, Evvy’s test detects over 700 microbial species, including those linked to conditions like bacterial vaginosis (BV), yeast infections, and aerobic vaginitis (AV). Your results include personalized insights and clinical guidance, helping you understand what’s going on in your vaginal ecosystem and what next steps might support fertility and overall reproductive health.