IDENTIFICATION OF MAIN RISK-FACTORS FOR TUBAL INFERTILITY

Objective: To determine the relationship between some reproductive var iables and infertility caused by tubal obstruction. Design: A retrospe ctive, case-control study. Setting: A tertiary care university hospita l that is a referral center for infertility patients. Participants: Su bjects were interviewed between March 1990 and December 1991. Cases we re 215 consecutively recruited infertile women with either evidence of tubal obstruction found at laparoscopy or hydrosalpinx diagnosed by h ysterosalpingography. Women with a history of surgical sterilization w ere excluded. Controls, selected in the same hospital, were women in t he puerperium who had no history of infertility. Two controls were mat ched by age at the time of tubal obstruction diagnosis to each case. R esults: History of pelvic surgery and use of alcohol were significantl y associated with the risk of infertility caused by tubal obstruction. The use of barrier, oral, and medroxyprogesterone acetate (MPA) contr aceptives was associated with a protective effect. When only women wit h secondary infertility were analyzed, history of pelvic surgery and n umber of lifetime sexual partners were significant risk factors, and t he previous use of oral contraceptives was the only protective factor. Conclusions: History of pelvic surgery was the most important risk fa ctor for tubal infertility. All precautions must be taken to avoid inf ection and adhesion formation when pelvic surgery is performed. In add ition, women can be protected from tubal infertility by using barrier, oral, or MPA contraceptive methods.