title: Is induced abortion a contributing factor to tubal infertility in Mexico? Evidence from a case-control study.
abstract: OBJECTIVE
  To determine the contribution of induced abortion to tubal infertility in Mexico.
  
  
  METHODS
  Population- and hospital-based case-control study.
  
  
  METHODS
  Tertiary hospitals in Mexico City.
  
  
  METHODS
  Women between 20 and 40 years with infertility and controls of the same age: 251 cases, 502 hospital controls, 502 neighbourhood controls.
  
  
  METHODS
  A case-control study was conducted in four tertiary hospitals in Mexico City with 251 cases and 1004 controls (two hospital and two neighbourhood controls per case, matched by age [+/-2 years]). Cases were infertile women, aged 20-40, with tubal occlusion confirmed by laparoscopy. Controls were fertile women, who had carried a pregnancy to term within the last two years. Participants completed a previously validated questionnaire asking about reproductive history and induced abortion.
  
  
  RESULTS
  Our study did not show an association between induced abortion and tubal infertility among women that did not relate both events (cases vs hospital controls: OR = 1.57, 95% CI: 0.29-8.65; cases vs neighbourhood controls: OR = 0.82, 95% CI: 0.07-8.99) using conditional logistic models adjusting by marital status, number of pregnancies, age at first sexual intercourse and history of pelvic inflammatory disease. In contrast, early age at sexual debut and history of pelvic inflammatory disease significantly increased the risk of tubal infertility.
  
  
  CONCLUSIONS
  In Mexico, the lack of association between induced abortion and tubal damage causing infertility observed in this population might be explained by a shift toward "safer" abortion practices.
authors.affiliation: Instituto Nacional de Salud Pública, Cuernavaca, Mexico.
authors.forename: Luisa
authors.initials: L
authors.lastname: Torres-Sánchez
authors.forename: Lizbeth
authors.initials: L
authors.lastname: López-Carrillo
authors.forename: Henry
authors.initials: H
authors.lastname: Espinoza
authors.forename: Ana
authors.initials: A
authors.lastname: Langer
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects*; D000328:Adult; D016022:Case-Control Studies; D005184:Fallopian Tube Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000209:etiology*; D008800:Mexico / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors