About 1/3rd of all women diagnosed with subfertility have a tubo-peritoneal factor contributing to their condition. Most of these alterations in tubo-ovarian function come from post-inflammatory damage inflicted after a pelvic or sexually transmitted infection. Salpingitis occurs in an estimated 15% of reproductive-age women, and 2.5% of all women become infertile as a result of salpingitis by age 35. Predominant organisms today include those from the Chamydia species and the infection causes minimal to no symptoms – leading to chronic infection and consequently more damage. Again, a large proportion of patients suffering from pelvic infection contributing to their subfertility are undiagnosed to be having an infection. Chronic inflammation of the cervix and endometrium, alterations in reproductive tract secretions, induction of immune mediators that interfere with gamete or embryo physiology, and structural disorders such as intrauterine synechiae all contribute to female infertility. Infection is also a major factor in male subfertility, second only to abnormal semen parameters. Epididymal or ductal obstruction, testicular damage from orchitis, development of anti-sperm antibodies, etc are all possible mechanisms by which infection can affect male fertility.
Part of the book: Genital Infections and Infertility