Tubal damage in infertile women: prediction using chlamydia serology

• Published in: Human reproduction (Oxford) Vol. 18; no. 9; pp. 1841 - 1847
• Main Authors: Akande, Valentine A., Hunt, Linda P., Cahill, David J., Caul, E.Owen, Ford, W.Christopher L., Jenkins, Julian M.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.09.2003; Oxford Publishing Limited (England)
• Subjects: Adult; Aging; Antibodies, Fungal - blood; Chlamydia Infections - complications; Chlamydia Infections - diagnosis; Chlamydia Infections - immunology; Fallopian Tube Diseases - complications; Fallopian Tube Diseases - diagnosis; Fallopian Tube Diseases - microbiology; Fallopian Tube Diseases - physiopathology; Female; Fluorescent Antibody Technique - methods; Humans; Infertility, Female - etiology; Key words: chlamydia/infertility/pelvis/serology/tubal damage; Laparoscopy; Likelihood Functions; Middle Aged; Prognosis; Serologic Tests; Severity of Illness Index; chlamydia/infertility/pelvis/serology/tubal damage
• ISSN: 0268-1161; 1460-2350; 1460-2350
• DOI: 10.1093/humrep/deg347

BACKGROUND: The study explores the relationship between serum chlamydia antibody titres (CATs) and detection of tubal damage in infertile women. METHODS: The tubal status and pelvic findings in 1006 women undergoing laparoscopy for infertility were related to CAT, which was measured using the whole‐cell inclusion immunofluorescence test. RESULTS: A negative correlation between CAT and age was noted. A linear trend between serum CAT and the likelihood of tubal damage, including severe damage, was observed (P < 0.001). Titres in women with tubal damage (median 1:1024; range <1:64–1:4096) were significantly (P < 0.001) higher than in women with endometriosis alone (median <1:64; range <1:64–1:512) or those with a normal pelvis (median <1:64; range <1:64–1:1024). Women with positive titres were more likely to have pelvic adhesions than tubal occlusion unless titres were very high, when tubal damage was likely to be more severe. CONCLUSIONS: CATs are of predictive value in the detection of tubal damage and are quantitatively related to the severity of damage. For practical clinical purposes, Chlamydia serology is useful mainly as a screening test for the likelihood of tubal damage in infertile women and may facilitate decisions on which women should proceed with further investigations without delay.