**5. Impact of lower genital tract infection on fertility**

In general, cervicitis has a negative impact on pregnancy. When a woman is diagnosed with cervicitis, especially for those who have severe cervicitis, the possibility of infertility is high. When cervicitis occurs, the cervix secretes more discharge with large amount of WBCs and pathogens thus hindering normal vaginal environment. This changes the PH of the vagina and kills semen as if pyospermia exists. The activity of sperms will be limited and their living time will be shortened. Furthermore, WBCs can swallow the sperms. Moreover, because of the thick and purulent discharge, it is more difficult for semen to swim-up into the uterine cavity. Of clinical importance, long standing endocervicitis is usually associated with mucosal prolifer‐ ation with narrowing of the cervical canal and even inflammatory polyp formation preventing smooth ascend of sperms. In addition, severe untreated longstanding cervicitis can cause infertility by affecting nearby organs. It may cause endometritis, cervical endometriosis, acute or chronic PID, tubal blockage, hydrosalpinx and even more deeper infections like urinary diseases. In such cases, treatment becomes more sophisticated and requires more aggressive lines of management. Lastly, local genital medications would affect sperm quality and adds another fertility obstacle.
