Clinical observation of infertility caused by pelvic bacterial or Chlamydial trachomatis infection

QUAN Song; YANG Xiao-yan; XU Jing-ping; ZHANG Jun; TIAN Jing-mei; YU Yan-hong

doi:10.3321/j.issn:1673-4254.2001.04.014

Abstract：Objective To investigate the different clinical and laparoscopic characteristics of infertility caused by pelvic bacterial infection in comparison with that caused by Chlamydial trachomatis. Methods Infertile patients with pelvic bacterial infection or with Chlamydial trachomatis infection were enrolled in this study, and in each group, 50 subjects were randomly selected for clinical observation and laparoscopic examination. Results In the infertile patients with pelvic bacterial infection, 24.4% had a history of uterine problems that required intra-uterine operation, and 43.3% and 78.6% experienced pelvic inflammatory diseases and lower abdominal pain respectively; these 3 problems, in contrast, were found to occur in 6.2%, 8.9% and 37.5% infertile patients with Chlamydial trachomatis infection, respectively (P<0.05). Laparoscopically, 35.7%, 14.4% and 17.4% bacterium-infected patients suffered pelvic adhesion, oviductal swelling or hydrosalpinx, and partial obstruction of the oviducts, respectively, which compromised 14.2%, 27.9% and 39.6% patients with Chlamydial trachomatis infection (P<0.05). In terms of primary and secondary infertility, the occurrence rates were 30.3% and 69.7% in bacterium-infected group vs 52.7% and 47.3% in the other (P<0.05). Conclusions The clinical manifestations of pelvic bacterial infection are typical with a history of intra-oviductal operation, episodes of acute pelvic inflammation and lower abdominal pain; laparoscopic examination reveals pelvic adhesion and oviductal damages. Pelvic infection with chlamydial trachomatis does not present typical features and laparoscopically shows oviductal lesions, liable to result in infertility, and its diagnosis and early treatment are difficult.