Histological Evaluation of Fallopian Tubes in Tubal Factor Infertility with Past Pelvic Inflammatory Disease

Background: A Persistent history of pelvic inflammatory disease (PID) causes mucosal damage and fibrosis, as well as hydrosalpinx, which eventually results in tubal patency and fertility. The present study aimed to determine the histopathological features of fallopian tubes of women with tubal factor infertility with a history of PID. Methods: A descriptive cross-sectional study was conducted on 180 women who had tubal factor infertility and previous documented PID after having undergone surgical tubal sampling. A non-probability consecutive sampling technique was used. Clinical and demographic information was recorded, and the surgical specimens of the fallopian tubes were processed for histological examination on hematoxylin & eosin and special stains. Histopathologic parameters of interest were assessed, including mucosal integrity, inflammatory infiltrate, fibrosis, hydrosalpinx, granulomatous inflammation, and vascular changes. Associations were examined between clinical indicators and the severity of tubal damage using chi-square tests, t tests and logistic regression. Results: In 30.0% of specimens, there was a complete loss of the mucosal surface, while moderate/severe fibrosis occurred in 67.7% of specimens. Chronic inflammatory infiltrates were seen in 71.1%, while hydrosalpinx was observed in 40.6% of the specimens. Women with ≥2 PID episodes had significantly greater plasma cell counts (p = 0.001) and 3 times greater risk of having severe tubal damage (p = 0.002). Conclusion: Repeated PID, long-term infertility, and hydrosalpinx constitute important indicators of severe tubal histopathology, further confirming the need for early management of PID and timely tubal assessment to optimize fertility potential.