[Epidemiology of tubal lesions. Apropos of 588 microsurgical plastic procedures and 69 in vitro fertilisations].

Genital infections and in particular sexually transmitted diseases are mainly responsible for tubal sterility. We have studied five factors each of which could carry responsibility for this sterility. All were in some degree associated with infection in the 588 patients who were operated on for tuboplasty and 69 patients who had in vitro fertilisation. There results have been compared with 50 sterile women who had healthy tubes and with 8,356 women who were delivered during the same period of time. The previous histories of women who had extra-uterine pregnancies were significantly more frequent for these infections in the tubes leading to chronic salpingitis. Acute salpingitis was given in the history in about 35% of women who had to have tubal surgery or in vitro fertilisation. This was significantly higher than those sterile women who had healthy tubes and those who were delivered of babies. There was a significantly raised number of those where the serology was positive for chlamydia trachomatis in sterile women with tubal lesions. We have also been able to note that there was correlation between the frequency with which positive serology was found and the degree of severity of the tubal lesions. So, the serology was often positive in cases of hydrosalpinx (77.3%) and in double lesions (91.5%). These figures were significantly higher than those who had proximal blocks (61%) and who had adhesions (54.8%). The frequency of therapeutic terminations of pregnancy in patients with tubal lesions was significantly higher than those in the control groups.(ABSTRACT TRUNCATED AT 250 WORDS)