Might be that a lady’s been aware that there was some infection. She perhaps had some antibiotics a few years ago but no obvious consequences at the time but in fact what’s happened there is, she’s ended up with infection within the pelvis and that’s caused some degree of tubular occlusion. So those kinds of things it’s important if people are thinking about conception that they’re aware that there are things that may have happened to them in the past that are highly relevant to the chance of them getting pregnant.
Pelvic inflammatory diseases or sexually transmitted illnesses are one of the causes that might cause infertility in the future. Mainly, for example, chlamydia is one of those bugs that is associated with tubal disease and it has been associated with the tubes being blocked in the future. Not every lady who gets chlamydia will end up having a blocked tube but we know that ladies who had chlamydia before are at a higher risk of having a tubal illness and a tubal illness will be associated with infertility. Other causes that sexually transmitted illnesses might cause infertility if it’s not only involves the tube but if the infection causes endometritis or infection of the lining that might also prevent embryos from implanting. Other causes which will be a little bit extreme in the pelvic inflammatory disease, if a lady developed a complicated form of pelvic inflammatory disease called tubo-ovarian abscess, for example, where there’s literally pass collection in the ovary, around the ovary and in that area obviously that might also impact ovarian reserve because we assume that the tubo-ovarian abscess might have destroyed some of the ovarian tissue that is present. So for this reason, we always advise any lady who has any risk of having a sexually transmitted disease, discuss it with your GP, discuss it with your doctor – the sooner you take the treatment, the earlier you clear the infection, the lower the complications will be in the future.
That is a very nice question. We actually are talking about pelvic inflammatory disease (PID)- this is a very serious and dangerous situation not only for fertility patients but also for the patients’ health.
There are various degrees of pelvic inflammatory disease. It could be a soft PID which can be treated with antibiotics or it can be a severe PID where the patient must be hospitalised.
In any case for the fertility patients, we know that unfortunately it affects all gynaecological organs which means: ovaries, ovarian quality, the fallopian tubes that after PID they really do not work and they should be removed but also the endometrium. Today we know that many patients who had PID in the past have problems conceiving because endometrium is suffering from chronic or acute endometriosis.
Patients who know that they have PID and come to our office should be very well monitored and very well seen because we suspect that there can be many damaged tubes, endometrium and ovaries.
Pelvic inflammatory disease may lead to fertility problems in different ways. First and most simple way is the effect of fallopian tubes’ potency and the inflammation can cause blockage of the tubes thus making a meeting of oocyte and sperm impossible. Moreover inflammation can cause disturbances inside the tube which will block embryo transportation into the uterine cavity and in such cases ectopic pregnancy can occur. Probably a more rare problem is ovarian inflammation which can lead to ovarian insufficiency affecting ovarian reserve, ovulation function, corpus luteum formation and its function. If someone has pelvic inflammatory disease this person can have problems conceiving. Without any attempt to conceive, they cannot say that person has infertility but we always need to check fallopian tube potency if our patient has the history of pelvic inflammation or sometimes we even can see signs of this inflammation and blocked tubes flood inside them thus we can suspect formation of hydro saltings- structure full of blood and all these findings can be a reason of conception failures.
