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Abstract

Pelvic inflammatory disease (PID) is a significant gynecological pathology and is the predominant etiological factor underlying tubal factor infertility. Ascending polymicrobial infections, which are predominantly attributable to Chlamydia trachomatis and Neisseria gonorrhoeae, initiate an inflammatory cascade in the upper genital tract, culminating in salpingitis, tubo-ovarian adhesions, and irreversible tubal occlusion. The resulting structural and functional compromise of the fallopian tubes significantly impairs fecundity and predisposes individuals to adverse reproductive outcomes, including ectopic gestation. This review synthesizes the current literature on the pathophysiological correlates linking PID to infertility, with emphasis on immunological mechanisms, diagnostic modalities, and therapeutic interventions. Contemporary research underscores the pivotal role of molecular diagnostics, advanced imaging modalities, and laparoscopic evaluation in delineating disease progression and informing clinical management. Furthermore, preventive strategies, including widespread screening for sexually transmitted infections, improved antimicrobial stewardship, and public health initiatives targeting high-risk populations, are essential to mitigate the disease burden. The integration of early intervention with long-term reproductive counselling remains indispensable for reducing the sequelae of PID and optimizing reproductive outcomes