title: The limited clinical usefulness of taking a history in the evaluation of women with tubal factor infertility.
abstract: OBJECTIVE
  To evaluate whether patient histories of gynecological infections predict tubal pathology seen at laparoscopic exam in infertile women.
  
  
  METHODS
  Cross-sectional analysis from a subset of case-control subjects.
  
  
  METHODS
  Tertiary-level public hospitals with infertility clinics, Mexico City.
  
  
  METHODS
  Three hundred twenty-one nulligravid infertile women seeking diagnostic workup.
  
  
  METHODS
  Interviews conducted before evaluation by laparoscopy.
  
  
  METHODS
  Sensitivity, specificity, and predictive values for correlating previous pelvic inflammatory disease symptoms, vaginal discharge, genital tract infections, and antibodies to Chlamydia trachomatis to confirmed diagnoses of tubal pathology and to severe tubal pathology.
  
  
  RESULTS
  Tubal pathology was found in 58% of participants (n = 185), and severe pathology was found in 29% (n = 92). None of the historical infection-related factors alone was a good overall predictor of tubal pathology; high sensitivity values (up to 73%) were offset by low specificity (down to 30%) and vice versa, for each factor. When considered simultaneously, the factors improved the overall predictive ability just slightly (84% sensitivity and 29% specificity) over the individual factors. The validity measures did not improve when examining severe tubal pathology alone.
  
  
  CONCLUSIONS
  History taking related to past genital tract infections appears to be of little use in the evaluation of infertile women.
authors.affiliation: Family Health International, Research Triangle Park, North Carolina 27709, USA. dhubacher@fhi.org
authors.forename: David
authors.initials: D
authors.lastname: Hubacher
authors.forename: David
authors.initials: D
authors.lastname: Grimes
authors.forename: Roger
authors.initials: R
authors.lastname: Lara-Ricalde
authors.forename: Julio
authors.initials: J
authors.lastname: de la Jara
authors.forename: Alonso
authors.initials: A
authors.lastname: Garcia-Luna
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002690:Chlamydia Infections / Q000175:diagnosis / Q000276:immunology; D002692:Chlamydia trachomatis / Q000276:immunology; D003430:Cross-Sectional Studies; D005184:Fallopian Tube Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D010535:Laparoscopy; D008487:Medical History Taking; D000292:Pelvic Inflammatory Disease / Q000150:complications; D011237:Predictive Value of Tests; D012044:Regression Analysis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014621:Vagina / Q000473:pathology