The pelvis is quite significant in female reproduction since it houses the majority of the reproductive organs. As a result of this same fact, pelvic inflammatory diseases (PID) have been proven to be a common cause of infertility among women. Generally, the disease of the pelvis starts off as a sexually transmitted disease (STD) caused by gonorrhoea or chlamydia infections of the cervix.
These illnesses are often without symptoms, or generally, cause some cervical discharge. The bacteria responsible for these illnesses could, in the cervix, ascend into the uterus and fallopian tubes resulting in a debilitating infection and an accumulation of pus in the tubes. The ascension of the disease can be stooped by the use of antibiotics in the early stages, however, the standard body defence, with or without antibiotics, will act by forming a walled-abscess over, and to include, the infectious bacteria.
The abscess will eventually solve in both ways. The abscess cavity would become sterilized, the fluid eventually cleared and the abscess then goes off, which can be better, or it ruptures and the disease then spreads farther to cause greater abscesses, which is quite bad for fertility. To get a better picture of how pelvic diseases affect fertility, you should note that, once a pathogenic bacteria like gonorrhoea or chlamydia will get access over the cervix into the uterus and uterine tubes, or even stopped by the use of antibiotics or detained by the body’s immune system, the interior surfaces of the tubes become denuded of the skin called the epithelia lining.
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Several white blood cells, in their effort to contain the disease, form a closed cavity around the pathogenic bacteria. This space becomes so full of the multiplying bacteria and fluids which that region of the tube become filled with pus. Even if handled at this point, the damage was done. The ruined lining of the tube can cause gluing with the walls of the tube, causing blockage of the tube afterwards, to both sperm and egg cells. For pregnancy to occur, the sperm cells and the ovum must meet from the tubes for fertilization to occur and the product of fertilization has to be hauled in the tube into the uterine cavity on time for implantation.
So, even if the tubes do not get blocked by agglutination of the walls because of stickiness due to previous infections, the destruction of the tubal lining still have an effect on fertility since the ciliary wave movement of the tubes which function to move the fertilized ovum to the uterus right on time for implantation, is missing. What could be worst is that, when the tubal abscess opens or flows from the end of the tube, the ovary at the end of the tube may stick with the tube and eventually become the far wall of another abscess cavity, which is now larger and more destructive.
This is referred to as a tubo-ovarian abscess and it causes a complete obliteration of fertility over the side it happens, because the tube, ovary and its eggs are destroyed. It’s estimated that 5-10% of women with PID develop the most severe form, tubo-ovarian abscess. Women with this condition are generally older (in their thirties and forties) and they also suffer acute pain and likely nausea, vomiting and abdominal distension. Pelvic inflammation disorder which has degenerated into abscess cavities is usually treated with a broad spectrum antibiotic.
The abscess is usually viewed as a mixed infection, because, however, the initial infection is often from a STD bacteria, multiple unique bacteria from the gut tract may become involved with the abscess because of transmigration across swollen, inflamed bowel walls surrounding the abscess area. Usually, at least two to three unique antibiotics are required immediately identification is made. If the infection does not improve, usually within 72hours, then some kind of surgical drainage of the abscess is necessary. If these fail, then as a last resort, exploratory operation removing all the infected tissue is performed.