PRIMARY INFERTILITY - CHARACTERISTICS OF WOMEN IN NORTH-AMERICA ACCORDING TO PATHOLOGICAL FINDINGS

Study objective - To determine, in women with primary infertility, whe ther specific characteristics or behavioural factors are associated wi th the various pathological conditions identified as contributing to t he infertility. Design - Case-control study. Setting - Seven instituti ons in the USA or Canada. Participants - Study subjects were 1750 wome n who presented with primary infertility, among whom the main patholog ical cause of infertility was male factor (417), tubal obstruction (23 1), endometriosis (194), luteal phase defects (153), other ovulatory p roblems (193), cervical abnormalities (92), and polycystic ovarian dis ease (84) and 1765 control women who delivered their first child at th e same institution. Main results - Except for tubal obstruction and po lycystic ovarian disease, the characteristics and behaviours of the wo men with infertility did not differ appreciably according to the patho logical conditions recorded. Women with tubal obstruction had had more sexual partners, an earlier age at first intercourse, were more likel y to have used an intrauterine device but less likely to have used a c ondom, and were more likely to have smoked cigarettes and to have used various recreational drugs than the other women. Women with polycysti c ovarian disease were more obese, had had fewer sexual partners, and were less likely to have used cigarettes, contraceptives, and recreati onal drugs than the other women. Conclusions - Sexually transmitted in fections seem to increase the risk of tubal obstruction but not other causes of infertility. Obesity is associated with polycystic ovarian d isease. These data offer few clues to the aetiology of infertility att ributed to endometriosis, cervical abnormalities, luteal phase defects , other ovulatory defects, or to male factors.