Is Subclinical Pelvic Inflammatory Disease a Significant Cause of Infertility?

Fallopian tube damage and obstruction — often consequences of prior pelvic inflammatory disease (PID) — remain significant causes of female infertility despite the decline in reported incidence of acute PID. To test the hypothesis that undetected subclinical PID might be an important cause of subsequent tubal infertility, investigators conducted a prospective observational study of fertility outcomes in previously pregnant women with (or at risk for) chlamydia or gonorrhea or with bacterial vaginosis. Women with acute PID were excluded. Endometrial biopsies were performed to identify endometritis and, thus, subclinical PID. Patients were treated as needed and were followed for subsequent pregnancy.

Subclinical PID was present at enrollment i…