Does chronic pelvic inflammatory disease affect ovarian reserve?

This paper studied the effects of blocked fallopian tubes, a symptom of chronic pelvic inflammation, on ovarian reserve (a measure of the supply of eggs). The authors reported that women with blocked fallopian tubes had lower levels of anti-Mullerian hormone, suggesting a reduced ovarian reserve.

Pelvic inflammatory disease is caused by an infection of the uterus, fallopian tubes, and ovaries. Pelvic inflammatory disease can sometimes lead to obstruction of the fallopian tubes. This is when the tubes which allow the egg to travel from the ovary into the uterus are blocked, which is a common cause of female infertility. However, it is unclear whether pelvic inflammatory disease damages ovarian reserve (a measure of the supply of eggs in women), an indicator of fertility. Ovarian reserve is often measured through the levels of anti-Mullerian hormone and the number of follicles (fluid-filled sac in the ovaries that contains an immature egg).

122 women with blocked fallopian tubes in both the right and the left side were included. 217 women without fallopian tube blockage were studied as a comparison. Hormone levels and number of ovarian follicles were compared between the two groups. Body mass index (BMI; a measure or the body weight that takes height into account) was also recorded.

The age and childbirth history between the two groups were comparable. On average, women with blocked fallopian tubes had a significantly higher BMI (22.89) compared to women without tube obstruction (21.64).

Women with tube obstruction had significantly lower levels of anti-Mullerian hormone (2.62 ng/ml) compared to women without tube obstruction (3.37 ng/ml). No difference in the number of ovarian follicles was observed between the two groups. There was also no difference in other hormones commonly involved in reproduction. These included luteinizing hormone, follicle stimulating hormone, estradiol, and testosterone.

The authors concluded that women with blocked fallopian tubes in both sides had lower levels of anti-Mullerian hormone. Authors suggested that chronic pelvic inflammation may damage ovarian reserve.

Further studies are needed to confirm these results.