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Extensive pelvic adhesions can result in cul-de-sac obliteration, defined by Sampson (1922) as “extensive adhesions in the cul-de-sac, obliterating its lower portion and uniting the cervix or the lower portion of the uterus to the rectum, with adenoma of the endometrial type invading the cervical and the uterine tissue”, which compromises sperm passage and tubal function

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