Human Reproduction, Vol. 18, No. 9, 1841-1847,
September 2003
© 2003 European Society of Human Reproduction and Embryology
Tubal damage in infertile women: prediction using chlamydia serology
1 University Division of Obstetrics and Gynaecology, St Michael’s Hospital, Bristol BS2 8EG, 2 Division of Child Health, University of Bristol and 3 Public Health Laboratory, Myrtle Road, Bristol, UK
4 To whom correspondence should be addressed. e-mail: valentine.akande{at}bristol.ac.uk
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.
Key words: chlamydia/infertility/pelvis/serology/tubal damage
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