Risk factors in men and women consulting for infertility.

In three regions of France, over a period of 1 year, we registered all couples (women and men) who have consulted and obtained a medical evaluation (medical causes and risk factors) for primary or secondary infertility. For women with secondary infertility caused by tubal disorders (compared to other causes) the risk factors are: STDs (RR = 7.5; 4.8-11.6); previous surgery, including appendectomy (RR = 4.7; 3.4-6.5); history of salpingitis (RR = 32.1; 18.8-55.3); and ectopic pregnancy (RR = 21.5; 11.4-41.3). For consulting men, secondary infertility risk factors are varicocele (RR = 4.1; 2.0-8.5) and previous genital infection (RR = 5.8; 2.8-11.7) for oligoteratosasthenospermia, and histories of major treatment or exposure to toxic agents such as X-rays, benzenes, or pesticides (RR = 6.6; 1.3-30.4) for secretory azoospermia. These results underline the importance for physicians of making a systematic exploration for all the different infertility risk factors in men and women, enabling greater control and effectiveness in medical diagnosis.