Human Reproduction, Vol 12, 925-929, Copyright © 1997 by Oxford University Press
A Neuer, KN Lam, FW Tiller, L Kiesel and SS Witkin
Recent evidence suggests that Chlamydia trachomatis can persist in the
female upper genital tract in an unculturable state. Since unsuspected C.
trachomatis infection has been associated with adverse in-vitro
fertilization (IVF) outcome we sought to detect further evidence of C.
trachomatis in the genital tracts of women undergoing IVF. The prevalence
and distribution of antibodies to the major structural proteins of C.
trachomatis in paired follicular fluid and sera of women undergoing IVF
were examined. Sera and follicular fluid samples from 149 women were
assayed for immunoglobulin (Ig)G and IgA antibodies to two C. trachomatis
antigens, the major outer membrane protein (MOMP) and a recombinant
lipopolysaccharide (rLPS) fragment. Additionally, the expression of human
60 kDa heat shock protein (hsp 60) in follicular fluid was determined. All
cervical and follicular fluid samples were negative for C. trachomatis by
polymerase chain reaction, ligase chain reaction and DNA probe. Sera from
60% of the subjects were positive for antichlamydial rLPS IgG; 36% were
positive for anti-MOMP IgG. Similarly, rLPS-directed and MOMP-directed IgA
were detected in sera of 34 and 14% of the subjects respectively. IgG
antibodies to MOMP and rLPS were detected in 42 and 41% of the follicular
fluid examined respectively. Anti-MOMP IgA was identified in 8.7% of the
follicular fluid while 27.5% were positive for anti-rLPS IgA. Human hsp 60
expression was documented in 11.6% of the follicular fluid tested. IgA
antibodies to both MOMP (P = 0.03) and rLPS (P = 0.02) in follicular fluid
were associated with a failure to become pregnant after embryo transfer.
IgG antibodies in sera and follicular fluid and IgA antibodies in sera were
unrelated to IVF outcome. Similarly only anti- MOMP IgA (P = 0.02) and
anti-rLPS IgA (P = 0.04) in follicular fluid were correlated with human hsp
60 expression in follicular fluid. The unique association between IgA
antibodies to two chlamydial antigens in follicular fluid and both hsp 60
expression and IVF failure provides further support for the possibility
that a persistent upper genital tract chlamydial infection contributes to
IVF failure in some women.
ARTICLES
Humoral immune response to membrane components of Chlamydia trachomatis and expression of human 60 kDa heat shock protein in follicular fluid of in-vitro fertilization patients
Department of Obstetrics and Gynecology, Cornell University Medical College, New York, NY 10021, USA.
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