Justice
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(C) Tubo-uterine factors
The origin of infertility is similarly due to male or female factors; the causes are multiple. Female factors account for 32% of infertility. Male factors account for 18.8% of infertility. Male and female factors combined cause 18.5% of fertility. The etiology is unknown in 11.1%, and other causes are identified in 5.6%.
Those with an unknown etiology can also be categorized as a normal infertile couple (NIC), indicating that all findings from standard tests used to evaluate the patients are normal. In NICs, the actual cause for infertility cannot be detected because it may be at the oocyte/sperm level or it may be due to the quality of the embryo or to any disruption at the implantation site level. In the future, ascribing the mutation or the absence of a specific gene as the cause of infertility may be possible in this patient population.
Other etiologic factors have been associated with an increased risk of infertility. These include pelvic inflammatory disease (PID); endometriosis; environmental and occupational factors; toxic effects related to tobacco, marijuana, or other drugs; exercise; inadequate diet associated with extreme weight loss or gain; and advanced age.
Pelvic inflammatory disease
PID has been associated with gonorrhea infection for more than a century (Brand, 1985). While gonorrhea still plays an important role in tubal disease, it has been surpassed by chlamydia. Westrom reported a 21% incidence of infertility in a group of Swedish women who were diagnosed with PID, which was confirmed by laparoscopy findings (Westrom, 1975). The rate of damage to the fallopian tubes increases with subsequent PID episodes, from 34% for the first episode to 54% in women with second and third episodes (Westrom, 1980).
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| Aashi
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A ----------> Peritoneal factor ( kaplan obgyne and blueprints)
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| NE
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I know A is the USMLEworld's answer but I am not very sure; besides Kaplan and blueprints all articles have almost the same conclusion- tubo- ovarian factors!
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| yasmeen
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i don,t know how u have modified this q but most common cause of infertility is indeed tubal diseases according to many text books
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| arlete
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What would be a peritoneal factor?
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| fongch
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Endometriosis is one
arlete wrote:What would be a peritoneal factor?
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| arlete
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Isn't PID more common then endometriosis?
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| Justice
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Guys,
After reading the the UW explanation, I have an impression that there is no clear sense of what the pure peritoneal vs tubo-uterine causes are... PID is the most frequent pathology leading to adhesions in the pelvis thereby altering the tubal passage... Whereas pathophysiologically this is the tubo-uterine case, it is judged to be the peritoneal one. That's where I see the confusion.
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