The Impact of Pelvic Inflammatory Disease on Infertility Outcomes

Abstract

Mabrouka Elbosafi and Khuloud Ajaj

Background: The pelvic inflammatory disease (PID) is defined as chronic inflammation and infection of the uterine lining (endometritis) and fallopian tubes (salpingitis) which affected frequently reproductive age women and results on chronic pelvic pain, recurrent PID and infertility (tubal factor).

Aim of The Study: This study aimed to determine the impact of pelvic inflammatory disease on infertility outcomes. Methods and Materials: This study was retrospective case series study which conducted on multicenter private sectors (Balsam clinic, Rosemary clinic and Alnajah clinic) on Tripoli, Libya over duration from January 2015 to February 2024. Out of 500 infertile Libyan women who diagnosed by pelvic inflammatory disease which selected from medical files were included. The relevant data were extracted through standardized questionnaire by investigator during time period. The data was encoded and analyzed via SPSS program version 24.

Results: The mean age was 27.52 ± 6.202 SD, the majority of patients had primary infertility accounted for 86.8% (434) while just 13.2% (66) of them had secondary infertility with the mean duration of infertility was 4.52 ± 2.112 SD. Based on clinical manifestations at presentation, 85.8% (429) had associated urinary symptoms, 84.8% (424) had abnormal uterine bleeding, 81.8% (409) had chronic pelvic pain, 76.2% (381) had pelvic heaviness, 53.2% (266) had vaginal discharge, 13.4% (67) had dysmenorrhea and 6.6% (33) had dyspareunia. On hysterosalpingogram pictures evaluation had revealed right tube obstructed on 13.2% (66), left tube obstructed on 18.6% (93) and bilateral tubal obstruction on 14.2% (71). 48.2% (241) had moderate hydrosalpinx followed by 38.6% (193) had mild hydrosalpinx and 13.2% (66) had severe hydrosalpinx. By hysteroscopic evaluation, 50.8% (254) of patients had chronic endometritis. The mean frequency of Tubal patency test (TPT) or intraoperative hydrocupration procedure sessions was 2.46 ± 0.813 SD. Based on management outcomes, 67.0% (335) of patients had successfully managed by medical regime only while 33.0% (165) were required additional hysteroscopy intervention. And all patients had successfully became pregnant followed the management protocol.

Conclusion: Although, the pelvic inflammatory disease among infertile women can be complex but effective strict management of medical protocols along with intraoperative hydrocupration procedure sessions had pronounced outcome and increase pregnancy rate even among complicated severe hydrosalpinx.

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