Cutting out fertility myths

Women who have had their appendixes removed are actually more likely to conceive a child afterwards, rather than less. This is what our latest large-scale study, published in the journal Fertility and Sterility, has found which flies in the face of the classic view that appendectomies harm a woman’s chance of having a baby because they cause scar tissue to form in the pelvis, potentially blocking one or both fallopian tubes.

But that seems to be a myth. Our results are quite compelling. Pregnancy rates were significantly higher among those who had had an appendectomy (54.4 per cent), than those in the rest of the population (43.7 per cent).

We examined the anonymous medical records of hundreds of thousands of women in the United Kingdom to get to our conclusion, which also showed that women who had had their tonsils removed had higher pregnancy rates too. Time to pregnancy was also shortest among those who had both an appendectomy and tonsillectomy. It was important that we included tonsillectomies in our study because we wanted to see if the same benefit could be gained from removing lymphoid organs wherever they sat in the human body. The results suggest that it is the removal of these organs which is key to increased rate of pregnancies.

And why should that be the case? One theory is that these vestigial organs (which are important in babyhood when they help to boost the immune system but become redundant later in life) are both prone to inflammation and infection. This inflammation weakens the body and reduces the chances of conception. When these organs are removed surgically, the woman has a chance to grow stronger and become healthier overall and this affects her fertility. Another possibility is that this is behavioural. So women who have a more liberal view of sexual intimacy are more likely to have pelvic infections and throat infections caused by direct contact with multiple partners. When they have repeated trips to the doctor complaining of swollen tonsils or sore abdomens, they may be more likely to be referred to a surgeon.

What we are certainly not advocating is that women seek to have an appendectomy or tonsillectomy to increased their chances of having a baby. There is no evidence that this would work anyway for the general population who do not have repeated infections.

The good news is that young women who have undergone an appendectomy because of medical necessity no longer need to fear that they have permanently damaged their chances of having a family. There is no evidence for that at all.

The researchers utilised the world’s largest digital repository of medical records from primary care, the UK Clinical Practice Research Databank. Their analysis included 54,675 appendectomy-only patients, 112,607 tonsillectomy patients, and 10,340 patients who had undergone both procedures. These were compared to the records of 355,244 women from the rest of the population, matched for age.

The results of the study are published in the journal of Fertility and Sterility. The paper can be viewed here: 10.1016/j.fertnstert.2016.06.022