Many medical conditions can contribute to infertility. In fact, most cases of infertility are due to underlying medical problems. These disorders can damage the fallopian tubes, interfere with ovulation, or cause hormonal problems.
Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) is a major cause of female infertility worldwide. PID comprises a variety of infections caused by different bacteria that affect the reproductive organs, appendix, and parts of the intestine that lie in the pelvic area. The sites of infection most often implicated in infertility are in the fallopian tubes, a specific condition referred to as salpingitis.
Causes of PID. PID may result from many different conditions that cause infections. Among them are:
- Sexually transmitted diseases (cause of most PID). Chlamydia trachomatis is an infectious organism that causes 75% of infertility in the fallopian tubes. Gonorrhea is responsible for most of the remaining cases.
- Pelvic tuberculosis
- Nonsterile abortions
- Ruptured appendix
Effects of PID. Severe or frequent attacks of PID can eventually cause scarring, abscess formation, and tubal damage that result in infertility. About 20% of women who develop symptomatic PID become infertile. PID also significantly increases the risk of ectopic pregnancy (implantation of the embryo in the fallopian tubes). The severity of the infection, not the number of the infections, appears to pose the greatest risk for infertility.
Endometriosis is a condition in which cells that line the uterus grow in areas outside of the uterus, such as the ovaries. The condition can interfere with a woman's ability to become pregnant. Endometriosis may account for as many as 30% of infertility cases. Endometriosis rarely causes an absolute inability to conceive, but, nevertheless, it can contribute to it both directly and indirectly.
Review Date: 11/10/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.