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November 26, 2017

Tonsillectomy Associated with Increased Pregnancy / Fertility Rates

Image courtesy of nenetus at FreeDigitalPhotos.net
A reader pointed this interesting research article from the United Kingdom that suggests females who have undergone tonsillectomy and/or appendectomy had increased fertility rates compared to women who have had neither surgeries. Fertility in this study was measured by time to pregnancy after surgery.

The results reported are as follows:

• During a mean follow-up of about 15 years after surgery, 53.4% of women who underwent tonsillectomy only became pregnant. 59.7% of women who underwent both appendectomy and tonsillectomy became pregnant. These numbers are significantly higher than the 43.7% pregnancy rate in an age-matched cohort of women who had neither surgeries.
• Time to pregnancy was also shorter for women who underwent tonsillectomy compared to women who did not.
• Age at first birth was also lower for women who underwent tonsillectomy (25.8 years control vs 24.5 years for tonsillectomy group).

Reasons why this association exists is speculative, but is thought to be related to systemic inflammation that may be present with chronic or recurrent tonsil infections.

Removal of the inflamed tonsils is thought to reduce overall systemic inflammation that may improve the overall health of the uterus and embryo resulting in a higher chance of a successful pregnancy. When inflammation due to tonsils becomes too excessive or chronic or consists of specific mediators in high enough concentrations, it might cause degeneration of the embryo and impaired implantation.

Inflammatory conditions adversely affecting fertility has been found to be true with other medical illnesses including inflammatory bowel disease and rheumatoid arthritis.

The researchers concluded by stating that guidelines should be adjusted such that young women suffering from recurrent tonsillitis should have a lower threshold for tonsillectomy.

References:
Association between prior appendectomy and/or tonsillectomy in women and subsequent pregnancy rate: a cohort study. Fertility and Sterility. Volume 106, Issue 5, Pages 1150–1156. October 2016.




Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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