The Association of Appendectomy, Adhesions, Tubal Pathology, and Female Infertility

• Published in: Journal of the Society of Laparoendoscopic Surgeons 2019-01, Vol.23 (1), p.e2018.00099
• Main Authors: Margaux Becker, Victoria, Silver, Saskia, Seufert, Rudolf, Muensterer, Oliver J
• Format: Article
• Language: English
• Subjects: Adult; Appendectomy - adverse effects; Cohort Studies; Fallopian Tube Diseases - diagnosis; Female; Humans; Infertility, Female - etiology; Laparoscopy; Retrospective Studies; Scientific Paper; Tissue Adhesions - diagnosis
• ISSN: 1086-8089; 1938-3797
• DOI: 10.4293/JSLS.2018.00099

The aim of the study was to investigate a potential association between previous childhood appendectomy, tube pathology, and female infertility. We reviewed patients seeking care at the fertility clinic of our university medical center between 2006 and 2016. The history of previous appendectomy was extracted from hospital documentation and by telephone follow-up. Tubal patency was assessed by diagnostic laparoscopy and chromopertubation. In our study cohort (N = 237), 24.9% (n = 59) had a history of previous appendectomy. Previous appendectomy, therefore, was about 3-fold more prevalent in women seeking fertility treatment than in the general population. Patients with previous appendectomy had more intra-abdominal adhesions ( < .001) and patients with adhesions tended to have compromised tubal patency ( = .05). However, there was no direct correlation between a previous appendectomy and tube pathology ( = .727). Because previous appendectomy was associated with intra-abdominal adhesions, and these were in turn associated with tube pathology, but appendectomy was not directly associated with compromised tubal patency, previous appendectomy may indirectly affect female fertility through mechanisms other than direct tubal obstruction. This is one of the largest study analyzing laparoscopic chromopertubation in association with previous childhood appendectomy.