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Human Reproduction, Vol. 15, No. 5, 1079-1082, May 2000
© 2000 European Society of Human Reproduction and Embryology

The value of Chlamydia trachomatis antibody testing as part of routine infertility investigations

K. Thomas1,4, L. Coughlin2, P.T. Mannion3 and N.G. Haddad2

1 Reproductive Medicine Unit, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, 2 Department of Obstetrics and Gynaecology and 3 Public Health Laboratory, Countess of Chester Hospital, Chester CH2 1UL, UK

Laparoscopy is considered the gold standard for the evaluation of tubal disease but it is an invasive and costly procedure. Chlamydia trachomatis antibody testing is simple and inexpensive and causes minimal inconvenience to the patient. Using the micro-immunofluorescence technique we assessed the significance of positive serology. There was a marked association between the titre and the likelihood of tubal damage. In the group with low titres (1 in 32) there was only a 5% incidence of tubal damage; however, there was a progressive increase in the incidence of tubal damage in those with higher titres. Twenty out of 57 patients with titres higher than 1 in 32 had tubal damage (35%). The difference between the two groups was statistically significant (P < 0.0001, {chi}2 test). By using C. trachomatis antibody testing more widely it may be possible to reduce the number of laparoscopies performed. It should therefore become an integral part of the fertility work-up.

Key words: antibody/Chlamydia trachomatis/hysterosalpingography/laparoscopy/tubal damage

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