How Can I Get Pregnant With Genital Herpes?

Contributor: Julie Kirk
Young couple lying on couch

What if you have a history of genital herpes infection, your partner doesn't, and you want to have a baby together? How can you get pregnant without infecting him? What do you do if instead, he has a history of infection and you do not; or you both do? In any of these situations, knowing how the virus behaves and how it sheds and spreads can help you plan how to time unprotected sex to get pregnant.

Getting Pregnant With Genital Herpes

If you have a history of genital herpes and you want to conceive naturally, the challenge is to time unprotected intercourse at your most fertile time, yet not infect your partner. The same applies if your partner is the one infected, and you are not.

As with everything in life, there is no guarantee the non-infected partner will not acquire the virus, but taking the best approach together will certainly limit the risk while you are trying to get pregnant.

Timing of Unprotected Sex

Young couple kissing in bed

Genital herpes, caused by the herpes simplex virus, is transmitted through sexual contact - either genital to genital or anal, or oral to genital, according to the American Congress of Obstetricians and Gynecologists. Take note that even when you don't have open herpes sores or other symptoms of infection, you can still shed the virus and infect your partner or vice versa.

To decrease your chance of passing the virus to your non-infected partner, follow these guidelines:

  • Use latex condoms up to your most fertile days and limit unprotected sex to only your most fertile days.
  • Have unprotected intercourse only if you don't have any active, open sores (herpes outbreak), even if you are at the most fertile time of your cycle.
  • Also avoid unprotected sex if you have symptoms, such as tingling or soreness around your genitals, that suggest a herpes outbreak is near.
  • If your partner is the one who is infected, he should take the same precautions while you are trying to get pregnant.

If you both have a history of genital herpes, then unprotected sex between you is not an issue. However, if either of you have open lesions, you should still avoid unprotected sex, even if you are at the best time in your cycle to get pregnant.

Identifying Your Most Fertile Days

To limit unprotected intercourse to only your most fertile days, and therefore decrease the chance of sharing the virus, it is helpful to know:

  • You can track one or more signs of fertility, such as your cervical mucus changes, or by using an ovulation predictor kit.
  • Observing fertility signs will help you figure out when you might ovulate and therefore the days in your menstrual cycle you are most likely to get pregnant.
  • It will be easier to figure out your fertile window if your cycles are regular.

Once you know when you might ovulate, have unprotected sex only on the one to two days before ovulation and the day of ovulation, as long as you don't have active herpes lesions or other signs of infection.

The Ovulation Predictor Kit

To help you predict when you might ovulate so you limit unprotected sex to your most fertile days, an easy tool is the ovulation predictor kit (OPK). According to a study published in 2000 in Human Reproduction, an OPK (or LH kit) is a reliable predictor of when ovulation is likely to occur. The at-home urine test measures the pituitary luteinizing hormone (LH), which increases as you approach ovulation.

Using the OPK to Time Intercourse

The ovulation predictor test helps you time intercourse as follows:

  • The day you see your strongly positive result is the day of the biggest increase in your LH secretion from your pituitary gland.
  • In the average 28-day menstrual cycle, you will see this result around day 12 or 13.
  • This "LH surge" is what triggers release of an egg from your ovary (ovulation).
  • The LH surge predicts that ovulation will likely occur 24 to 36 hours later - around day 13 to 14 of a 28-day cycle.
  • Have intercourse the day of the surge and about 36 hours later.
Illustration of sperm racing to an egg

This is your best fertile window for live sperm to catch the egg while it is still fertilizable. The timing takes into account the lifespan of the sperm and the egg. According to Clinical Gynecologic Endocrinology and Infertility (page 1285), sperm can survive in a woman's reproductive track for three to five days. The egg is only viable for fertilization from 12 to 24 hours.

Antiviral Medications

There is no cure for herpes, but medicines can modify the pattern of the disease process, according to the Centers for Disease Control and Prevention (CDC) 2015 Sexually Transmitted Disease Treatment Guidelines. Taking an antiviral herpes medicine daily (suppressive therapy) might make it less worrisome and stressful to get pregnant with genital herpes. Daily treatment can:

  • Suppress the virus and decrease viral shedding and transmission
  • Decrease the frequency of herpes outbreaks
  • Reduce the chance of passing the virus to your partner or the other way around

Acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) are the choices of medicines used for herpes suppressive therapy, according to the CDC guidelines. Ask your doctor about taking suppressive therapy while you are trying to conceive.

Other Options to Have a Baby

If you prefer not take a risk of sharing the virus through unprotected sex, you and your partner might want to consider alternate ways to have a family. These options include:

  • Artificial insemination with your partner's or donor sperm
  • In vitro fertilization, which can be complex and expensive
  • Surrogacy: If you have the virus and your partner doesn't, and you want to avoid the concerns of transmitting herpes to your baby during pregnancy, you might want to consider using a surrogate to carry the baby. The cost of surrogacy can also be expensive.

Genital Herpes and Reproduction

Concept image of virus reproduction

Additional facts about genital herpes and reproduction include:

  • Herpes simplex does not adversely affect the reproductive tract, egg production, or ovulation.
  • It typically doesn't affect sperm production or quality.
  • Rarely, a fetus will acquire the herpes simplex virus from placental transmission from the mother during pregnancy. This can increase the risk of miscarriage or preterm delivery.
  • A baby can get sick and may die if he acquires herpes from his infected mother during vaginal birth, according to MedlinePlus.
  • If a mother has an active infection or is shedding the virus near term, a cesarean section is recommended to avoid the risk of newborn infection.
  • Herpes does not pass through breast milk, so you can safely breastfeed your baby. However, do not breastfeed if you have open herpes sores on your breasts or anywhere your baby can touch.

A doctor might also suggest a mother take daily herpes suppressive therapy starting at 36 weeks to reduce the chance of passing the virus to the fetus.

Can Herpes Cause Infertility?

In general, it is not believed that genital herpes can cause infertility. However, a couple of studies did show a connection.

Strains and Unexplained Female Infertility

One recent study found that there was a link between a certain strain of herpes (not the traditional genital herpes strain) and unexplained infertility in women. This study showed that 43% of 30 women with unexplained infertility had a uterine lining that was infected with this specific herpes strain (HHV-6A). However, the 36 women in the study who had no problems conceiving were not found to have the herpes strain in their uterine lining.

Study on Male Infertility

Another study showed the effect of genital herpes on male infertility. It was determined that having genital herpes may lower sperm count which, in turn, may affect your chances of getting pregnant. Herpes may actually be a significant factor in unexplained infertility for men.

Outbreaks Are Common Complications

A common complication that may also occur is if it is time to try to conceive and you have a herpes outbreak. This could delay intercourse and therefore interfere with potential conception and pregnancy.

Other Important Facts About Genital Herpes

The following important facts from the Centers for Disease Control and Prevention (CDC) will give you an additional perspective on genital herpes as you consider your options to get pregnant.

  • Genital herpes is common in the United States, affecting one in 16 people ages 14 to 49.
  • Most of those infected with herpes simplex have had minor or no active symptoms.
  • More women are infected than men, and men pass the disease to women more frequently than vice versa.
  • Herpes simplex type 2 causes most cases of genital herpes, while type 1 mostly infects the mouth and is responsible for "fever blisters."
  • People infected with genital herpes only shed the virus 10% of the time when there are no lesions.

In the absence of lesions, a doctor can swab your genital area and send it to test for herpes simplex DNA to see if you are shedding the virus. However, because the virus only sheds 10% of the time, a negative test doesn't mean you don't ever shed virus.

Ways to Transmit the Virus

In addition to the risk of transmitting the virus to a partner through an open herpes lesion or through shedding from skin, other routes of sharing the virus include:

  • Fluid in a herpes blister
  • Contact with the mucus lining of the mouth or vagina
  • Through secretions from the mouth, vagina, or penis

Condoms and Herpes

You and your unaffected partner should use latex condoms when you are not trying to get pregnant. However, condoms don't fully protect because uncovered genital areas can still transmit the virus. In addition, if you are the one infected and you have ever had unprotected sex with your partner before, he may already be infected and not know it because he never had symptoms.

Getting Pregnant Is Possible With Genital Herpes

For most people, having a diagnosis of genital herpes can be stressful and life-changing. Because there is no cure, trying to get pregnant can be challenging but not impossible. Knowing the essentials about the virus and how to decrease the chance of infecting your partner (and vice versa), and how and when to time intercourse can help you get pregnant safely. Talk to your doctor for more help and insight.

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How Can I Get Pregnant With Genital Herpes?