Discussion
Couples may present to their physicians
complaining of infertility after failing to conceive for
months or years. Tubal damage is a common cause
of infertility, and laparospcopy or hysterosalpingography
are accepted methods for diagnosing this
condition(5). The prevalence of tubal infertility varies
greatly from one area to another(6,7). The present
study demonstrated that the prevalence of tubal
abnormalities among infertile females who attended
the clinic at Srinagarind Hospital was 27.30%. This
figure was comparable to 29.7% prevalence previously
reported from Ramathibodi Hospital in Bangkok,
Thailand(6). This prevalence, however, was relatively
lower than that reported by Cates et al which revealed
that, during the 1980s, the prevalence of tubal obstruction
among infertile patients was 36% in developed
countries, 39% in Asia, 44% in Latin America, and 85%
in Africa(2). The discrepancy between the prevalence
reported by Cates and that of the present study could
partly be explained by the fact that these two studies
were conducted in different time frames. The studies
by Cates et al analysed the patients seeking infertility
treatment during the 1980s, about one decade earlier
than the time period being investigated in the
present study. This time-frame difference, therefore,
could result in alterations in several factors attributed
to the occurrence of tubal abnormalities and hence
the difference in its prevalence. Genital Chlamydial
trachomatis infection has a worldwide distribution(8)
and is now recognised as the single most common
cause of tubal peritoneal damage(9,10). As personal
recognition regarding genital hygiene has been
improved over time, it thus seems justified to foresee
the decreasing trend of tubal infertility as time passes.