That pathology and the general inflammation of the pelvic structures results in infertility, which occurs in about 1/5 of women who’ve had at least one episode of PID, and in up to half of women who’ve had three or more episodes of PID. Once a woman has had one episode, she’s much more likely to get subsequent episodes. It may be an autoimmune phenomenon, or it may be that these women are more likely to be involved with sexual partners who are re-infecting them. Either way, we know statistically that these women are much more likely to have subsequent episodes. Once they’ve had several episodes they are very likely to become infertile. All of these data, these quoted statistics, come from a single cohort study that was done in Scandinavia about a generation ago. It ran from about 1960 to 1985. These women who were enrolled in cohort studies were women who had a laparoscopy, which is the gold standard for making the diagnosis of PID – it’s a procedure where you take an instrument and look inside the perineum and you can see these red, inflamed, pussy tubes and ovaries – and after they had that diagnosis made, they were subsequently followed for up to decades. That is the basis on which we make these claims.