[Etiologic factors in tubal sterility]

Between the years 1977 and 1982, laparoscopy was performed on 900 patients where the diagnosis of infertility was made in our department. In the patients' histories events which were considered relevant to subsequent tubal pathology were studied in detail. These potential risk factors were further analyzed and related to the finding of tubal pathology at the time of diagnostic laparoscopy. Patients with moderate or severe endometriosis were excluded from this study, because the high incidence of tubal adhesions in these women rendered it impossible to analyse the relationship between potential risk factors in the patients' histories and the incidence of tubal infertility. The incidence of tubal disease in patients with only one risk factor was compared to patients with no such factors in their history. The incidence of tubal pathology was significantly higher in all categories except the group who had undergone only uncomplicated appendicectomy. Highly significant differences were found after salpingitis, ovarian cystectomy or wedge resection and "complicated" appendicitis. The risk of a low-grade salpingitis was increased after induced abortion and IUD usage. The incidence of tubal pathology (33.7%) in patients without risk factors lends support to the assumption that salpingitis can occur without obvious clinical symptoms and appears to justify laparoscopy and use of antibiotic treatment if salpingitis is suspected in young women, even though clinical symptoms are absent.