Causes of Infertility: PELVIC INFLAMMATORY DISEASE
Causes of Infertility: PELVIC INFLAMMATORY DISEASE
Pelvic Inflammatory Disease (PID) refers to conditions that affect pelvic structures including the uterus, fallopian tubes, ovaries, bowel, and the smooth membrane that lines the surface of the pelvic cavity (the peritoneum). PID follows infection which reaches pelvic structures as a result of:
- sexual transmission via the vagina and cervix
- contamination from other inflamed structures in the abdominal cavity (appendix, gallbladder, kidneys, etc.)
- a foreign body inside the uterus (i.e., the intrauterine device – IUD)
- contamination of retained products of conception following abortion or child birth
- quite rarely as a result of blood-born bacterial transmission (e.g., pelvic tuberculosis which is common in developing countries but rare in the United States.
It has been estimated that about 1,300,000 women develop PID annually in the United States. Less than one-third of these women present with acute pelvic inflammatory disease. The remaining cases usually go undetected until the woman presents with symptoms of infertility. In fact, more that 60% of patients who undergo surgery or in vitro fertilization and embryo transfer (IVF/ET) for the treatment of infertility secondary to pelvic inflammatory disease, provide no history of acute PID.
In the vast majority of cases, PID results from the sexual transmission of infecting organisms such as Neisseria Gonorrhea, and Chlamydia Trachomatis, which are readily eradicated through appropriate antibiotic therapy. Sexually transmitted bacteria first infect the cervix (the opening into the uterus) through which it ascends via the uterus to the fallopian tubes, ovaries, and other pelvic structures.
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