Infertility: Investigation of impaired ovarian function as a contributing factor to infertility in women with pelvic adhesions*

A prospective study was performed to determine whether a relationship exists between infertility as a result of pelvic adhesions, and raised follicle stimulating hormone (FSH). A total of 66 patients, who had a diagnostic laparoscopy and dye performed as part of their infertility work-up, had an early cycle serum FSH drawn one to two cycles after this procedure. Patients were divided into two groups, one with pelvic adhesions as a result of surgery, infection or endometriosis, and a control group consisting of those with a normal pelvis at laparoscopy or with minimal/mild endometriosis without adhesions. In the adhesion group, a correlation was noted between American Fertility Society (AFS) adhesion score and basal FSH concentration, although all FSH values for this group were within the normal range. This study suggests a correlation between pelvic adhesions and ovarian compromise, but a larger study involving more severe cases of adhesions is required to determine whether this finding is of clinical importance.