# Pelvic Inflammatory Disease and Infertility



## Anthony Reid (Jan 1, 2002)

*Pelvic Inflammatory Disease and Infertility*

Pelvic Inflammatory Disease (PID) is an infection of a woman's uterus and fallopian tubes. Infertility is a common result of PID infection. Scar tissue caused by PID can hinder correct ovulation or may obstruct the passage of an egg through the fallopian tubes. This can lead to permanent infertility. PID usually occurs in women between the ages of 15 and 24.

Chlamydia is the most common cause of PID. It is estimated that 40% of women who have Chlamydia will develop PID. PID caused by Chlamydia often results in little or no symptoms. This means that the infection may go unnoticed until there is irreversible damage. Not only can PID decrease the chances of pregnancy, it can also increase health risks to a baby. There is a danger of miscarriage, premature birth, and stillbirth. It is estimated that about 10% of women who contract Chlamydia will become infertile as a result of PID.

PID can cause injury to the fallopian tubes that transport eggs from the ovaries to the womb. Fallopian tubes may stop working or become completely blocked. Scarring of the uterus and fallopian tubes can greatly decrease the chances of fertilization and pregnancy. Women with damaged fallopian tubes can become pregnant, but there is an increased risk of the pregnancy developing in the fallopian tubes instead of the womb. This is known as an ectopic pregnancy. The fallopian tube can tear causing severe pain and bleeding. Bleeding can be a life threatening condition.

*Other Sources of PID Infection*

PID can be caused by many types of bacteria, but conditions are normally caused by bacteria from the two sexually transmitted infections, Chlamydia trachomatis and Neisseria gonorrhoea. Both infect a woman's cervix making it easier for bacteria to enter reproductive organs. This can happen if the cervix has been damaged, if a woman has had PID before, or if the cervix has been opened during a surgical procedure. PID caused by bacteria from Gonorrhoea can cause severe symptoms such as high fever and abdominal pain.

*Invitro Fertilization and PID*

Invitro Fertilization is not an effective answer to PID infection. There is an increased risk of an ectopic pregnancy. Research has shown that if a woman has PID and becomes pregnant, she will have about a 1 in 10 chance that the pregnancy will be ectopic.

*Risk Factors*

Sexually active women under the age of 25 have the highest risk of developing PID, with most cases occurring in teenagers. Young women tend to have more sexual partners and practice unsafe sex which are two high risk behaviours for contracting PID. Another youth connected aspect that may influence the advancement of PID is cervical mucus. Thick cervical mucus can shield the cervix from some types of bacteria such as gonorrhoea. Young women in their teens tend to have thin mucus which makes them more susceptible to foreign bacteria.

*PID Treatment*

Treatment is with antibiotics. The earlier treatment is started, the less the risk of complications. Sexual partners should also be treated. Women are less likely to develop problems they begin treatment within 2-3 days of symptoms starting. This may be possible if symptoms develop quickly. Some women with PID have minor symptoms or no symptoms causing the infection to advance before it is diagnosed and treated.

*PID Prevention*

The best way for women to prevent PID is to protect themselves from sexually transmitted diseases. Always use a barrier routine of contraception during sex. Condoms and femidoms offer the best protection. A diaphragm or cervical cap with a spermicide may also help prevent Gonorrhoea and Chlamydia. Regular sexual health checks are very important. This will help with early diagnosis and treatment. If you are concerned that you have PID, contact your health professional


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