Recurrent Pelvic Inflammation Ups Infertility, Pelvic Pain

Nearly doubles infertility risk; ups chronic pelvic pain more than four-fold

FRIDAY, Nov. 11 (HealthDay News) -- Recurrent pelvic inflammatory disease (PID) is associated with a nearly two-fold increase in infertility and more than four-fold increase in chronic pelvic pain (CPP), according to a study published in the September issue of Sexually Transmitted Diseases.

Maria Trent, M.D., M.P.H., from the Johns Hopkins School of Medicine in Baltimore, and colleagues investigated the link between subsequent sexually transmitted infections (STIs) and recurrent PID on infertility and CPP. Longitudinal data were collected from 831 women participants from the PID Clinical Health and Evaluation study (between 1996 and 1999). Participants (aged 14 to 38 years) with mild to moderate PID were randomized to inpatient and outpatient antibiotic treatment arms. They were interviewed at baseline, underwent gynecological examination, and specimens were collected to test for Neisseria gonorrhoea, Chlamydia trachomatis, bacterial vaginosis, and endometritis through biopsy. Infertility and CPP at 84 months were the main outcome measures.

The investigators found that 21.3 percent of women had recurrent PID at 84 months; and 19.0 and 42.7 percent were infertile or had CPP, respectively. After multivariable adjustments, women with recurrent PID were 1.8 times more likely to report infertility and 4.2 times more likely to report CPP, than those without recurrent PID. Compared to women without STIs, those with subsequent STIs were 2.3 times more likely to develop CPP but were not more likely to have infertility.

"Recurrent PID was associated with an almost two-fold increase in infertility and more than four-fold increase in CPP," the authors write.

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