EFFECT OF PELVIC INFLAMMATORY DISEASE ON FERTILITY

Genital infections, in both men and women, may cause permanent functio nal damage to the reproductive tract resulting in infertility. In men, post-infection infertility is uncommon, whereas in women sequelae aft er pelvic inflammatory disease (PID) is the most common cause of acqui red infertility. In a prospective cohort study of women who all sought pregnancy after laparoscopically verified acute (non-tuberculous) sal pingitis, 141/1,309 (10.8%) were infertile because of proven post-PID tubal occlusion. In 448 control women, the corresponding figures were 4/448 (0.9%). Of independent and significant importance for post-PID i nfertility were the numbers of PID episodes (0/1/2/greater than or equ al to 3: RR's 1.0/7.0/16.2/28.3), and in women with only one PID episo de, the severity of infection (mild/moderate/severe; RR's 1/1.8/5.6), delayed care (<3/greater than or equal to 3 days; RR 1/2.8), use of co ntraceptives (none/pills/IUD's/'other'; RR's 1/0.3/0.5/0.8). Similar i nfluences of the same variables were also demonstrated for subfertilit y, i.e. ectopic pregnancy, and time between index laparoscopy and preg nancy in those women who conceived after PID.