Abstract
Dense pelvic adhesions can arise as a result of pelvic infection, endometriosis, peritonitis, or pelvic surgery. The burnt-out disease is associated with evidence of a chronic inflammatory response. One of the chemical mediators of inflammation is histamine; and human and animal studies have indicated a role for histamine in the ovulatory process. In women with dense pelvic adhesions we have found significantly elevated concentrations of histamine in the follicular fluid when compared with the follicular fluid obtained from women without adhesions. This may lead to premature ovulation during a normal cycle, resulting in the release of an immature oocyte. It is possible that this may contribute to the lower fertility in women who have pelvic endometriosis but patent fallopian tubes, and in those patients where tubal patency has been restored following tubal surgery.