In both men and women, STD-associated genital infections may cause permanent damage to the reproductive tract resulting in sub- or infertility. In men, the wide zone between sterility and normal fertility makes it difficult to demarcate the precise role of infection on post-infection fecundity, but it seems less important than in women. The reproductive events were studied in a cohort of 1,309 pregnancy-seeking women, < or = 35 years of age, after laparoscopically verified acute salpingitis, and 451 women with normal laparoscopy. Tubal factor infertility (TFI) was diagnosed in 12.1% of the patients and 0.9% of the controls, and the first pregnancy was ectopic in 7.8% and 1.3%, respectively. Of independent importance for infertility, ectopic pregnancy, and time between PID and first intrauterine pregnancy were number of infections, severity of the infections, contraception at the index laparoscopy, age, and delayed treatment. STD-associated in-subfertility is acquired and, hence, preventable.