Etiological factors in tubal infertility.

An analysis was made of the history of 820 patients who underwent diagnostic laparoscopy for infertility reasons. Events in the patient's history related to abdominal surgery, infection of the genital tract, and endometriosis were compared with the incidence of tubal disease at laparoscopy. Salpingitis, puerperal endometritis, gynecologic operations such as ovarian cystectomy, wedge resection, and operative correction of uterine retroversion and appendicitis complicated by perforation of the appendix, inflammatory mass or appendiceal abscess, were all associated with a significantly higher incidence of tubal disease. In patients that had undergone an uncomplicated appendectomy, the occurrence of tubal abnormalities was not increased (42%), when they were compared with the group with a completely negative history (37%). Implications of these findings with relation to the prevention of tubal disease are discussed.