Pelvic Inflammatory Disease and Involuntary Infertility: Prospective Pilot Observations

Soper, David E.; Ness, Roberta B.

doi:10.1155/s1064744995000494

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…This is the second long-term follow-up study in the United States after laparoscopic confirmation of acute PID. 18 In the first report, 56% of 18 patients were involuntarily infertile after 1 year. 18 The 40% rate of infertility in this population was identical to the 40% rate of infertility among a similar population in San Francisco, where PID was diagnosed by clinical criteria.…”

Section: Discussionmentioning

confidence: 99%

Infertility Following Pelvic Inflammatory Disease

Pavletic

Wölner-Hanssen

Paavonen

et al. 1999

Infectious Diseases in Obstetrics and Gynecology

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Section: Discussionmentioning

confidence: 99%

Infertility Following Pelvic Inflammatory Disease

Pavletic

Wölner-Hanssen

Paavonen

et al. 1999

Infectious Diseases in Obstetrics and Gynecology

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“…18 In the first report, 56% of 18 patients were involuntarily infertile after 1 year. 18 The 40% rate of infertility in this population was identical to the 40% rate of infertility among a similar population in San Francisco, where PID was diagnosed by clinical criteria. 19 A history of PID prior to the index episode of PID was also present in about 40% of both this and the San Francisco population.…”

Section: Discussionmentioning

confidence: 99%

Infertility following pelvic inflammatory disease

Pavletic

Wølner‐Hanssen

Hawes

et al. 1999

Infect. Dis. Obstet. Gynecol.

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Objective To assess the frequency of infertility after pelvic inflammatory disease (PID) and factors important in postinfectious tubal damage in an urban population at high risk for sexually transmitted diseases. Methods From a cohort of 213 women with PID documented by laparoscopy and/or endometrial biopsy, 58 women (27% of the initial cohort) were interviewed by phone 2 to 9 years after an index episode of PID. Data regarding the initial history, physical examination, microbiology, laparoscopic, and serologic findings, and data concerning interval contraception, subsequent pregnancy, subsequent infection, and chronic pelvic pain were compared among those with and without infertility at follow up. Results Nineteen (40%) of the 48 women not using contraception were involuntarily infertile after the index episode of PID. Compared with those who had an interval pregnancy, infertile women were older (P = 0.02), more likely to have a history of infertility prior to the index episode of PID (P = 0.001), and were more likely to have occluded or partially occluded fallopian tubes (P = 0.03), peritubal adhesions (P = 0.007), or perihepatic adhesions (P = 0.02) seen by laparoscopy performed during the index episode. Surprisingly, recovery of Chlamydia trachomatis was negatively related to infertility (P = 0.001), although a similar proportion of both groups had chlamydia immunoglobulin M antibody (40% vs. 31%). Chlamydia heat shock protein was weakly related to infertility (P = 0.08). The isolation of Neisseria gonorrhoeae was not significantly different between groups (53% vs. 57%). Conclusions The high rate of postinfection infertility found was probably related to a combination of tubal damage before and during the index episode of PID. Prevention of recurrent PID and better understanding of the pathophysiology of postinfection tubal damage (which may differ between chlamydia and gonorrhea) is needed to develop more effective strategies to reduce permanent tubal damage. Infect. Dis. Obstet. Gynecol. 7:145–152, 1999. © 1999 Wiley‐Liss, Inc.

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