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Do Pelvic Inflammatory Diseases Impact Fertility?

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Have you ever wondered, how infection of the pelvis is linked to infertility? The burden of infertility is often reduced by knowing the cause behind it and treatment thereafter. This is exactly what pelvic inflammatory disease (PID).

This blog will explore pelvic inflammatory diseases and how they impact fertility.

Pelvic Inflammatory Disease (PID) is a term used for infections of female reproductive organs. These infections mostly happen during unprotected sex. The exchange of bacteria spreads from the vagina to the uterus, ovaries or fallopian tubes and gets settled in the woman’s reproductive organs.  No wonder these Pelvic inflammatory diseases are called ascending diseases.

The condition is usually seen in sexually active women during their fertile years. Commonly found organisms such as Neisseria gonorrhoeae and Chlamydia trachomatis are some of the known general cause of pelvic inflammatory disease. However, microorganisms that can be a part of the vaginal flora such as Gardnerella vaginalis, Haemophilus influenza and Streptococcus agalactiae can also cause PID.

Pelvic Inflammatory Diseases can affect the uterus, ovaries and fallopian tubes which are part of the female reproductive system. No doubt, it is not only painful but also poses challenges to conceive in the future. The disease could also further progress to a pelvic infection called TOA (tubo-ovarian abscess), which is a stubborn and serious complication too.

Fallopian tubes pick up the egg and help in the transport of the embryo into the uterus after the egg is fertilized. If tubes are blocked sperm and egg can’t fuse and infertility follows. IVF is the best option in such cases of tubal defect.

Pelvic infections (chlamydia or gonorrhoea), and pelvic inflammatory disease (PID) are the most common causes of tubal disease.

PID could cause pain in the lower abdomen along with abnormal vaginal discharge. One usually gets PID through unprotected sex primarily.

PID can impact the uterus, ovaries and fallopian tubes, Pelvic inflammatory disease is irritating and painful, and it can reduce the ability to conception if untreated. This disease could also lead to a pelvic infection called TOA (tubo-ovarian abscess), which is a severe form. PID is a Polymicrobial infection which means, it is caused by many pathogens.

What are the Symptoms of Pelvic Inflammatory Disease?

Most of the time, patients complain of,

• Lower abdomen pain, which may worsen when moving • pain during or after sex • bleeding between periods or after sexual activities • lower back pain • inflammation in the lower abdomen • fever• abnormal vaginal discharges   • nausea and vomiting • leg pain • increased menstrual pain • increased pain at ovulation • dysuria, frequent urination etc.

What happens if Pelvic Inflammatory Diseases are undertreated?

Complications and long-term problems associated with Pelvic Inflammatory Diseases are

• Recurrent PID • Ruptured abscess • Chronic pain • Ectopic pregnancy • Infertility

Does the screening of male partner necessary?

Pelvic Inflammatory Disease is sexually transmitted so Management of Sex Partner is necessary

• Male sex partners of women should be examined for pelvic inflammatory disease and  to be treated as most of such cases are frequently asymptomatic.

Sex partners should be treated empirically with antibiotics effective against both C. trachomatis and N. gonorrhoeae, regardless of pathogens isolated from the infected woman.

Who are at greater risk of Pelvic Inflammatory infection?

Menstruating teenagers. ● Women with Multiple sexual partners. ● Absence of contraceptive pill use. ● Previous history of acute PID. ● IUD users.

How is Pelvic Inflammatory disease diagnosed?

To learn if you have PID, your gynaecologist will start by asking for medical history, including sexual habits, birth control methods, and symptoms. If you have PID symptoms, you are advised to have a pelvic exam. This exam can reveal tenderness of reproductive organs. A fluid sample will be drawn from the cervix and tested for gonorrhoea and chlamydia. Blood tests may be done.

Your gynaecologist may order other tests or procedures like ultrasonography, endometrial biopsy, or laparoscopy.

How is the pelvic inflammatory disease treated?

Pelvic inflammatory disease is treatable. There are antibiotics available which can control and treat the infection whereas, treatment of PID cannot reverse the scarring caused by the infection. Pelvic infection remains untreated or undertreated, and the risk for long-term problems, such as infertility sets in.

PID is treated first with antibiotics or combinations of antibiotics. These formulations of antibiotics are available in oral as well as injectable forms. A follow-up visit 2–3 days after treatment is checked to see the response to the antibiotics. Sometimes the patient is symptomatic much before the completion of the dosage of the antibiotic. It is mandatory to complete the course of antibiotics to avoid recurrence.

Can pelvic inflammatory disease be treated on OPD basis?

Yes, depending on the screening and culture report, Doctor will suggest a treatment but if patient don’t respond to the treatment, patient will be treated in a hospital. Hospitalization is necessary for women,

Do not have a clear diagnosis

Are pregnant

Must take IV antibiotics

Are severely ill

Have persistent nausea and vomiting

Have a high fever

Have localized collection of pus in a fallopian tube or ovary

Need surgery.

Can pelvic inflammatory disease be prevented?

Yes, while using condoms every time you have sex to prevent infections. Using condoms along with other birth control measures and ensuring the partner is sexually transmitted infection free.

Can pregnancy be achieved after treatment for pelvic inflammatory disease?

Most women with PID who received treatments, have no problems conceiving and becoming a mother in the future. However, if the case is of severe PID, it could damage fallopian tubes and affect your fertility and in such cases, you may need Assistive reproductive technologies.

What could be the reason for not getting pregnancy after treating PID?

As mentioned above, the antibiotics used to treat pelvic inflammatory disease cannot repair the damage already caused by the pathogen or bacteria. Antibiotics can only treat the infection and can prevent further damage to the reproductive organs. The most common cause of PID-related infertility is blocked fallopian tubes

Kindly read our blog on, blocked fallopian tube.


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