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Hum. Reprod. Advance Access originally published online on April 22, 2004
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Human Reproduction, Vol. 19, No. 6, 1380-1384, June 2004
© 2004 European Society of Human Reproduction and Embryology

The role of chlamydia genus-specific and species-specific IgG antibody testing in predicting tubal disease in subfertile women

J.E. den Hartog1,4, J.A. Land1, F.R.M. Stassen2, M.E.P. Slobbe-van Drunen2, A.G.H. Kessels3 and C.A. Bruggeman2

1 Research Institute Growth and Development (GROW) and Department of Obstetrics and Gynaecology, 2 Maastricht Infection Centre (MINC) and Department of Medical Microbiology and 3 Department of Clinical Epidemiology and Medical Technology Assessment, Academisch Ziekenhuis Maastricht, P.O.Box 5800, 6202 AZ Maastricht, The Netherlands

4 To whom correspondence should be addressed. e-mail: jedh{at}sgyn.azm.nl

BACKGROUND: We evaluated whether measuring chlamydia genus- and species-specific immunoglobulin (Ig) G antibodies might improve the predictive value of C. trachomatis antibody testing (CAT) in screening for distal tubal pathology (DTP). METHODS: Serum of 313 subfertile women was tested for the presence of species-specific antibodies to C. trachomatis, C. pneumoniae and C. psittaci and genus-specific antibodies to chlamydia lipopolysaccharide (LPS). Only patients who had undergone a laparoscopy with tubal testing, to assess the grade of DTP, were included in this study. RESULTS: The presence of C. trachomatis antibodies was the only independent predictor for DTP. The predictive value of CAT for DTP could not be improved by adding test results of C. pneumoniae or LPS antibody testing. The role of C. psittaci could not be evaluated, due to the absence of C. psittaci-positive patients in our cohort. CONCLUSIONS: In spite of the high interspecies homology, C. pneumoniae does not contribute to the development of DTP. Anti-LPS antibodies, which are considered to be markers for ongoing infections, do not identify C. trachomatis-positive subfertile women who are at highest risk of DTP. The high prevalence of anti-LPS antibodies in C. trachomatis-positive subfertile women may suggest that C. trachomatis remains more active in the upper genital tract than currently is presumed.

Key words: chlamydia/genus-specific antibodies/screening/species-specific antibodies/tubal factor subfertility


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