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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.
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.