Analysis of the factors associated with pelvic adhesions in infertility women

Objective: To explore the related factors with different degrees of pelvic adhesion in infertility women by laparoscopy.Methods:Three-hundred and nineteen infertile patients who were found with pelvic adhesion by laparoscopy were recruited.They were divided into three groups according to the severity of pelvic adhesion as follow: 122 with mild adhesion,84 with moderate adhesion and 113 with severe adhesion.There were 87 infertile patients without pelvic adhesion in the control group.Results:(1) There were much higher percentage of patients who had surgery history in each of the pelvic adhesion groups than the control group(16.4%,26.2%,20.4% vs 3.5%,P0.01).There were lower percentage of patients who had past pelvic inflammation in control group and mild adhesion group than those in severe adhesion group(6.9%,4.1% vs 15.0%,P0.05,P0.01).(2) The incidence of pelvic tuberculosis in the severe adhesion group was higher than that in control and mild adhesion group by laparoscopy(7.1% vs 0%,0.8%,P0.05).The rates of tubal obstruction and hydropyosalpinx in all of the pelvic adhesion groups were significantly higher than those in control group(21.1%,27.6%, 49.1% vs 9.9% and 5.7%,10.7%,18.6% vs 0%,respectively,P0.05).(3)The rates of ovarian endometriosis in all of the pelvic adhesion groups were significantly higher than these in control group(6.6%,15.5%,10.6% vs 0%,P0.05).Conclusions:Abdominal or pelvic operative lesions,pelvic inflammation and endometriosis could be important factors to induce pelvic adhesion in infertility women,and the incidence of those diseases is correlated with the severity of pelvic adhesion.