**Infection and Infertility**

Rutvij Dalal

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/64168

#### **Abstract**

About 1/3rd of all women diagnosed with subfertility have a tubo-peritoneal factor contri‐ buting to their condition. Most of these alterations in tubo-ovarian function come from post-inflammatory damage inflicted after a pelvic or sexually transmitted infection. Sal‐ pingitis 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, altera‐ tions 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.

**Keywords:** Infertility, Infection, pelvic inflammatory disease, salpingitis, epididymo-or‐ chitis, antisperm antibodies

#### **1. Introduction**

The association between infection and infertility has been long known. Of all causes of female Infertility, tubal or peritoneal factors amount to about 30-40. The infections that lead to asymptomatic infections are more damaging as lack of symptoms prevents a patient from seeking timely medical intervention and consequently chronic damage to pelvic organs. Indeed, timely management of sexually transmitted or other infections goes a long way in preventing damage, disability, chronic pelvic pain, altered tubo-ovarian relationship and consequently helps in maintaining fertility.

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Tubal and peritoneal pathology is among the most common causes of infertility and the primary diagnosis in approximately 30-35% of infertile couples. A history of pelvic inflam‐ matory disease (PID), septic abortion, ruptured appendix, tubal surgery, or ectopic pregnancy suggests the possibility of tubal damage. PID is unquestionably the major cause of tubal factor infertility and ectopic pregnancies. Classic studies in women with PID diagnosed by laparo‐ scopy have revealed that the risk of subsequent tubal infertility increases with the number and severity of pelvic infections; overall, the incidence is approximately 10-12% after one episode, 23-35% after two, and 54-75% after three episodes of acute PID.[1] The most frequent causes for pelvic infections are sexually transmitted pathogens and intrauterine manipulations like curettage, evacuation, etc.
