Highlights
Study shows that women who have their appendix and tonsils removed at a young age are more likely to get pregnant.
Women could also get pregnant more quickly, the study revealed.
Researchers warn not to have these operations unnecessarily.
The study also challenges the myth of the effect of appendectomy on fertility.
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Women who have had their appendix or tonsils removed appear to be more fertile, a 15-year study suggests.
The researchers, at the University of Dundee, analysed medical records from more than half a million British women.
They argue the operations could directly affect fertility or there may be a “behavioural” explanation.
Experts said the findings might lead to new treatments, but advised women not to have their tonsils and appendix taken out unnecessarily.
The study found that for every 100 pregnancies in women who had had no procedures there were:
- 134 pregnancies in women who had had their appendix removed
- 149 pregnancies in women who had had their tonsils removed
- and 143 pregnancies in women who had had both removed
Researchers from the University of Dundee and University College London studied the appendectomies and tonsillectomies records of thousands of women in UK and found that pregnancy rates were significantly higher among those who had an appendectomy (54.4%), tonsillectomy (53.4%) or both (59.7%) than the rest of the population (43.7%).
The results of the study also showed that the time taken to conceive was shortest among those who had both their appendix and tonsils removed, followed by women who had only appendix removed followed by women who had only tonsils removed.
The researchers used the records from the UK Clinical Practice Research Databank. Their current study included 54,675 appendectomy-only patients, 112,607 tonsillectomy patients, and 10,340 patients who had undergone both appendectomy and tonsillectomy. The results were compared to the records of 355,244 women of similar age from the rest of the population.
The same research team had conducted a study in 2012 which had revealed surprising statistics around appendectomies and pregnancy.
Explaining the findings, published in Fertility and Sterility, is more of a challenge.
One biological possibility is that regularly infected tonsils or appendixes raise levels of inflammation in the body, which affects the ovaries and womb.
The Dundee team favour a behavioural explanation such as women enjoying more “liberal sexual activity”, being both more likely to get pregnant and have pelvic inflammatory disease, which could lead to an appendix being removed.
More research is needed to figure this out.
‘Interesting paper’
Prof Allan Pacey, from the University of Sheffield, told the BBC: “This is an interesting paper which suggests that surgical removal of the appendix or tonsils (or both) in young women is associated with an increase in their fertility later in life.
“There are several explanations which may account for these observations, one of which is that the removal of these tissues makes an alteration to their immune system which has an impact to some aspect of the reproductive process (such as how their embryos implant in the womb).
“If true, this may ultimately give doctors and scientists some new ideas for novel drugs or therapies to enhance women’s fertility.
“But to suggest that infertile women have their tonsils or appendix removed as a way of improving their chances is a step too far at this stage.”
One of the clinical senior lecturer at Dundee University’s School of Medicine, Sami Shimi commented: “Once again the results have been surprising. We have found that women who have had an appendectomy or tonsillectomy, or even more particularly both, are more likely to become pregnant, and sooner than the rest of the general population. This scientifically challenges the myth of the effect of appendectomy on fertility. What we have to establish now is exactly why that is the case.”
Dr. Sami Shimi, who is also a consultant surgeon with NHS Tayside, said most doctors were wrongly taught that having an appendix removed damaged fertility.
Dr. Li Wei, who is associated with the School of Pharmacy at University College London, said, “This research is of paramount interest because appendectomy and tonsillectomy are very common surgical operations, experienced by tens of thousands of people in the UK alone. Although a biological cause is possible, we believe that the cause is more likely to be behavioral. We are pursuing both hypotheses with further research.”
The researchers caution that women should not seek an appendectomy or tonsillectomy to increase their chances of getting pregnant. However, they are of the opinion that young women could have their appendix removed without the fear of future fertility risks.
