Association between appendicectomy in females and subsequent pregnancy rate: a cohort study

Objective: To study whether subsequent pregnancy rate is reduced after appendicectomy. Design: A cohort study was carried out in the General Practice Research Database, a United Kingdom primary care database. Setting: University hospital. Patient(s): Female patients who underwent appendicectomy between 1986 and 2009 and appropriate comparators were followed until first pregnancy. Intervention(s): None. Main Outcome Measure(s): The association between appendicectomy and subsequent pregnancy was determined by Cox regression models. Result(s): The analyses included 76,426 appendicectomy patients, with 152,852 comparators from the database. There were 30,030 pregnancies (39.3%) in the appendicectomy cohort and 43,321 (28.3%) in the comparator cohort during a mean (SD) follow-up of 10.5 (6.6) years. Adjusted hazard ratios for subsequent birth rates were 1.54 (95% confidence interval, 1.52-1.56). Conclusion(s): Appendicectomy was associated with increased subsequent pregnancy rate in this study. This suggests that a history of appendicectomy is not associated with impaired fertility.