Collet M, Reniers J, Frost E, Gass R, Yvert F, Leclerc A, Roth-Meyer C, Ivanoff B, Meheus A
International Centre for Medical Research of Franceville CIRMF, Gabon.
Int J Gynaecol Obstet. 1988 Jun;26(3):423-8. doi: 10.1016/0020-7292(88)90340-2.
Determinants of infertility were studied in 340 women in Eastern Gabon, an area situated in the "infertility belt" of Central Africa. Fallopian tube occlusion was diagnosed in 82.8% of cases, showing the importance of infection-related causes. Women with tubal occlusion did not differ significantly from women with normal tubes in obstetrical history or prevalence of Neisseria gonorrhoeae or Chlamydia trachomatis on endocervical culture. Antecedents of pelvic inflammatory disease or a pelvic mass were significantly more common in the group with tubal occlusion. This group also had a significantly higher prevalence of serum chlamydial antibodies at a titer of 1/64 or higher. Hormonal factors were found in 31.7% of women, a cervical factor in 29.0% and mechanical factors in 5.6%. No diagnosis could be made in 12.2% of cases. During the investigation, 4.4% of women became pregnant. The predominance of infectious related causes of infertility makes it imperative to focus resources on prevention programs of upper genital tract infections in women.
在加蓬东部的340名女性中开展了不孕症决定因素的研究，该地区位于中非的“不孕症带”。82.8%的病例被诊断为输卵管阻塞，这表明感染相关原因的重要性。输卵管阻塞的女性在产科病史或宫颈管培养中淋病奈瑟菌或沙眼衣原体的患病率方面与输卵管正常的女性没有显著差异。盆腔炎或盆腔肿块的既往史在输卵管阻塞组中明显更为常见。该组血清衣原体抗体滴度为1/64或更高的患病率也显著更高。31.7%的女性存在激素因素，29.0%存在宫颈因素，5.6%存在机械因素。12.2%的病例无法做出诊断。在调查期间，4.4%的女性怀孕。不孕症感染相关原因占主导，因此必须将资源集中于女性上生殖道感染的预防项目。
