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The Value of Chlamydia Trachomatis Antibody Testing in Prediction of Tubal Factor Infertility
Sakine Moaiedmohseni,Monir Owje
Journal of Family and Reproductive Health , 2008,
Abstract: Objective: This study aimed to assess the value of Chlamydia trachomatis (C.trachomatis) antibody titer test in prediction of tubal damage. Materials and Methods: In this case-control study we enrolled 50 women with tubal factor infertility (proven by laparoscopy after hysterosalpingography) and 110 women without infertility history. ELISA was performed for all participants, seeking C.trachomatis IgG antibodies. ELISA for IgM was then performed for women with positive test. Statistical package for social science version 11 was used for data entry. Statistical evaluation was performed using student t test, Fisher exact and chi-square tests. Statistical significance was defi ned as P<0.05. Results: In 8(5%) of all women the C.trachomatis IgG antibody was positive .Five (10%) of the infertile patients and 3 (2.7%) of pregnant women had positive tests (P < 0.03). All of them had negative results for IgM antibodies. Twenty five percent of women with normal hysterosalpingography and 5.3% of women with abnormal hysterosalpingography had positive antibody test. There was not any correlation between antibody titer and abnormal HSG. Endometriosis was diagnosed in seven women with negative antibody results. Conclusion: The result of C.trachomatis antibody titer was significantly different in women with and without infertility Laparoscopic. Tubal assessment is recommended in infertile women with a positive result of the C. trachomatis antibody titer.
The Role of Chlamydia trachomatis IgG Antibody Testing in Predicting Tubal Factor Infertility in Northern Iran  [PDF]
Sepideh Peivandi,Narges Moslemizadeh,Saeideh Gharajeh,Abolghasem Ajami
International Journal of Fertility & Sterility , 2009,
Abstract: Background: The purpose of this study was to investigate the role of Chlamydia serology as ascreening test for tubal infertility and to compare the results with hysterosalpingography (HSG)and laparoscopic findings.Materials and Methods: This was a cross-sectional study undertaken on 110 infertile womentreated in the IVF Ward, at Emam Khomeini Hospital, Sari, Iran who underwent laparoscopy andHSG as part of their infertility workup.Prior to laparoscopy, 5 ml of venous blood was drawn for measurement of serum ChlamydiaIgG antibody titer (CAT). Patients’ tubal status and pelvic findings were compared with CAT, asmeasured by microimmunofluorescence.Results: Tuboperitoneal abnormalities were seen in 81.4% of seropositive patients versus 13.2%of women who were seronegative. In women with tubal damage, the numbers of positive CATs(≥1:32) were significantly more than in those who had a normal pelvis (66.6% vs. 6.5%, p<0.001).CAT levels were higher in patients who had bilateral hydrosalpinges, bilateral tubal occlusion andpelvic adhesions (severe damage), than those with tubal distortion and unilateral occlusion (milddamage) (p<0.05). The positive likelihood ratio for C. trachomatis antibody testing was 10.28 ascompared with HSG, which had a positive likelihood ratio of 3.03.Conclusion: The results of this study revealed that C. trachomatis serology is an inexpensive andnon-invasive test for tubal factor infertility screening.
Tubal Infertility and Chlamydia Trachomatis in a Congolese Infertile Population  [PDF]
E. Mboloko, M. Fataki, E. Nzau-Ngoma, L. D. Lokengo, A. Ingala, B. C. J. Bikuelo, A. N. Apangwa, M. M. M. Kapend, M. Mboloko, N. Mumba
Open Journal of Obstetrics and Gynecology (OJOG) , 2016, DOI: 10.4236/ojog.2016.61005
Abstract: Infertility of tubal origin is the most frequent in sub-Saharan area. It is due to tuboperitoneal lesions mainly because of infection; especially sexually transmitted infection. Worldwide, Chlamydia trachomatis is the main pathogen. In our setting, some studies failed to establish the link between tubal infertility and chlamydia trachomatis. The current study aimed to determine the local data related to chlamydia trachomatis role in tubal infertility and the usefulness of Chlamydia trachomatis antibody titer test (CAT) in discrimination of the patients with and without tuboperitoneal lesions. Patients’ average age was 33.9 ± 4.8 years, average coitarche 19.4 ± 4.4 years and average number of partners: 3.1 ± 1.6. The level of CAT is correlated to the tuboperitoneal severity. CAT was more specific (93.3%; CI 95%: 81.7 - 98.6) than sensitive (72.7% CI 95%: 49.8 - 89.3) and discriminated correctly 89% (AUC = 0.89) of the patients with or without tuboperitoneal lesions. In conclusion, as it is stated worldwide, Chlamydia trachomatis is the most frequent sexually transmitted pathogen associated with tubal infertility. CAT has to be used as a tool to select patients to be submitted to invasive investigation, like laparoscopy.
Hysterosalpingography Tubal Infertility in an Environment with Non Liberalized Abortion Law
Ademola A. Aremu,Daniel A. Adekanle,Chriatianah M. Asaleye,Victor A. Adetiloye
Research Journal of Medical Sciences , 2012, DOI: 10.3923/rjmsci.2012.142.144
Abstract: Most induced abortions in Nigeria are performed by non medical and paramedical personnel in unregistered health centers due to the non liberalization of abortion laws. This has resulted in increased abortion related complications. To determine the effect of induced abortions, especially by non medical doctors on hysterosalpingographic tubal abnormalities. The study included 110 consecutive infertile patients referred to the Radiology Department for Hysterosalpingography over a year period. Appropriate questionnaires were administered after informed consent and prior to the procedure (HSG). The data was analyzed using EPI info 2000 and the association between induced abortion and tubal abnormalities were measured using χ2-test and Fischer Exact test (where appropriate) and 2-sided p<0.05 was used as significant level. Past history of dilatation and curettage at unregistered hospitals (by non medical personnel) was found to be statistically significant for hydrosalpinges (p<0.01; odd ratio 15.6; 95% CF 3.05-106.49); tubal blockage (Fischer s exact 0.039; odd ratio 9.3; 95% CI = 1.05-18.19. Criminal abortions, often performed by quacks in Nigeria due to its illegality is found to be significantly associated with tubal pathology in infertile couples.
Comparison of Reproductive Outcome of Falloposcopic Tuboplasty for the Proximal Tubal Obstruction with or without Chlamydia Trachomatis Infection
Hiroshi Nabeshima, Takashi Murakami, Shinichi Hayasaka, Yukihiro Terada, Nobuo YaegashiKunihiro OkamuraChlamydia trachomatisIn vitro
The Open Reproductive Science Journal , 2008, DOI: 10.2174/1874255600801010005]
Abstract: Chlamydia trachomatis (CT) infection is a common cause of tubal factor infertility, and is considered a contraindication for tubal surgery. In vitro fertilization with embryo transfer (IVF/ET) is the most widely used treatment for tubal factor infertility, including that caused by CT infection. Falloposcopy to re-canalize occluded tubes may also be useful therapeutically. It is unclear, however, what effect CT infection has on its efficacy. We examined the relationship between the efficacy of Falloposcopic tuboplasty (FT) and CT infection, retrospectively. Of 38 patients with tubal obstruction in which the surgery was performed, with follow-up, 21 patients had CT infections while 17 patients were not infected. In the Chlamydia positive group (CT+), 38 tubes were treated with FT and 29 tubes were treated in the Chlamydia negative group (CT-). Re-canalization rates per tube was 60% in the CT+ group and 79% in the CT- group. The success rate per case was 90% in the CT+ group and 94% in the CT- group. Cases were followed-up using either hysterosalpingography or second look laparoscopy, and a post-operative patency rate of 56% in the CT+ group and 75% in the CT- group was observed. In patients in followed for two years or more, the CT+ group had 5 spontaneous pregnancies (36%) and the CTgroup had 9 spontaneous pregnancies (60%). There was a trend to better outcome in the CT- group, but there was no significant statistical difference between the two groups. In Conclusion, CT infection decreases fertility after FT. Despite CT infection having a negative impact on FT, the CT+ group had a post-operative pregnancy rate of 35.7%, which was comparable to IVF-ET. Given this, we recommend FT for patients who have isolated tubal occlusion before beginning IVF/ET, even if the patients were previously infected with CT.
Structural findings at hysterosalpingography in patients with infertility at two private clinics in Kampala, Uganda
Elsie Kiguli-Malwadde, Rosemary K Byanyima
African Health Sciences , 2004,
Abstract: Introduction: Hysterosalpingography (HSG) is still a commonly used investigation in the evaluation of the female genital tract and the main indication for HSG is infertility. Objective: The purpose of this study was to find the pathology detected at HSG in patients with infertility in our setting. Materials and Methods: A retrospective review of 289 consecutive patients who underwent hysterosalpingography using ionic water-soluble contrast media was done at 2 private x-ray units in Kampala. Clinical notes and radiological findings were analysed for demographic data, uterine status, tubal and pelvic pathology. Results: The commonest age group seen was 26–30yrs. Most were of low parity. Secondary infertility was commoner than primary infertility. Abnormal findings at hysterosalpingography were found in 83.4%. The commonest finding was tubal blockage. Conclusion: The commonest pathology found on HSG in women presenting with infertility in Kampala is tubal blockage possibly secondary to chronic pelvic inflammation. The fact that secondary infertility is common points to pelvic infection complicating mismanaged pregnancies, septic abortions or sexually transmitted infections. A study toestablish associated factors is recommended. Key Words: Hysterosalpingography, Infertility African Health Sciences Vol.4(3) 2004: 178-181
The Prevalence of Serum Immunoglobulin G Antibody to Chlamydia Trachomatis in Subfertile Women Presenting at the University of Port Harcourt Teaching Hospital, Nigeria  [cached]
Israel Jeremiah,Ola Okike,Chris Akani
International Journal of Biomedical Science , 2011,
Abstract: Objectives: This study was undertaken to assess the prevalence of IgG antibody to Chlamydia trachomatis in subfertile patients at the University of Port Harcourt Teaching Hospital and to determine associated factors between this and infertility.Study design: This case controlled study was conducted among 100 women presenting for infertility consultation at the University of Port Harcourt Teaching Hospital. One hundred women with normal intrauterine pregnancies attending the antenatal clinic were used as controls. A questionnaire was used to obtain information on their socio-demographic data, sexual and obstetric history administered to them. 2mls of venous blood was collected, labelled and sent to the laboratory. The presence of IgG antibody to Chlamydia trachomatis was determined. Hysterosalpingography was performed on all infertile women to assess tubal patency. Data management was with SPSS 15.0 for Windows statistical software.Results: The mean age of the subjects was 30 ± 3.1 years, median parity 0.5 and average life time sexual partner 3.7 ± 2.8. All the participants in the study were married. 62% of subjects had tertiary education. The Chlamydia trachomatis IgG antibody prevalence in the subfertile population was 74% and 51% in the control group, P<0.001. Tubal occlusion occurred in 58 (78.4%) of cases positive for chlamydia antibody. Pelvic inflammatory disease and mucopurulent discharge were the most common presentating symptoms among Chlamydia antigen positive infertile women, P<0.001. There was an association between subfertility and the number of life time sexual partners. There was an association between subfertility and non usage of condoms.Conclusion: The prevalence IgG antibody to Chlamydia trachomatis was significantly higher in women with subfertility compared to women with proven fertility. There was a strong association between Chlamydia antibody positivity and tubal occlusion. In a resource-poor country such as Nigeria, enzyme immunosorbent assay for chlamydial IgG antibodies may be substituted for HSG for the detection of tubal occlusion.
Laparoscopic evaluation of tubal factor in cases of infertility  [cached]
Shraddha K. Shetty,Harish Shetty,Supriya Rai
International Journal of Reproduction, Contraception, Obstetrics and Gynecology , 2013, DOI: 10.5455/2320-1770.ijrcog20130930
Abstract: Background: Tubal factor infertility accounts for approximately 25-35% of cases of female infertility. The evaluation of the fallopian tube is necessary to determine the management plan for infertility. Tubal patency can be diagnosed by hysterosalpingography (HSG) or laparoscopy with chromopertubation. The aim of this study was to determine the role of laparoscopy in the evaluation of tubal factor in infertile women. Methods: Fifty women presenting with complaints of primary and secondary infertility were investigated for tubal disease by laparoscopy at K. S. Hegde Charitable Hospital, Mangalore, from January 2007 to July 2008. Tubal patency was tested by chromopertubation using Methylene blue dye. Results: Thirty four (68%) patients were in primary infertility group while 16 (32%) patients were in secondary infertility group. 88% women were in the age group of 21 to 35 years. In 64% of women, the duration of infertility was between 1 to 5 years whereas 32% cases had been infertile for 6 to 10 years. Tubal pathology was detected in 64.7% cases of primary infertility and 68.7% cases of secondary infertility. Bilateral tubal occlusion was found in 8% and unilateral occlusion in 28% cases. Conclusion: Laparoscopy is an effective diagnostic tool for evaluation of tubal pathology. Laparoscopy and chromopertubation test should be recommended as a first step in the investigation of infertile women with tubal factor. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000): 410-413]
Chlamydial Infection, Plasma Peroxidation and Obesity in Tubal Infertility
AC Nsonwu-Anyanwu, MA Charles-Davies, AA Oni, VO Taiwo, FA Bello
Annals of Ibadan Postgraduate Medicine , 2011,
Abstract: Background: Genital tract infections and obesity are both sources of oxidative stress. Alterations in immune and antioxidant parameters may arise from this or from an indeterminate autoimmune mechanism. Objective: This study aimed to investigate the association of Chlamydial infection, obesity and oxidative response with tubal infertility in Nigerian women. Methods: It was a case-control study of 40 women with tubal infertility and 32 fertile women, respectively, recruited from the Infertility and Family Planning Clinics respectively, of the University College Hospital, Ibadan, Nigeria. Anthropometric indices were measured in each subject and endocervical swabs were taken to screen for current genital tract infection. Antioxidant, hormonal and immunologic analysis were performed on serum. Results: None of the subjects had current genital tract infections. Chlamydia trachomatis IgG positivity was significantly higher in infertile than in fertile subjects [OR 4.33; 95%CI (0.078-0.681)]. No significant variations were observed in the anthropometric indices, antioxidant parameters and hormones between infertile and the fertile women. Body mass index correlated positively with oxidative stress in infertile subjects. Waist and hip circumferences correlated negatively with oestradiol in women with tubal infertility. Conclusion: Chlamydial infection is associated with tubal factor infertility, however, obesity seems to increase oxidative stress and reduce fertility potential in women with tubal factor infertility.
Comparison of anti Chlamydia antibodies in tubal and non-tubal infertile patients
Z. Basirat,M. Sharbatdaran,F. Montazar
Journal of Mazandaran University of Medical Sciences , 2006,
Abstract: Background and purpose: Chlamydia trachomatis infection is one of the most prevalent bacterial sexually transmitted infection in most countries. This organism may stay in genital tract for long time and cause subtle yet progressive damage in fallopian tubes. In this study we evaluate the correlation between chlamydia antibodies and tubal and other factors of infertility.Materials and Methods: In this case control study, 28 patients with tubal factor infertility, 28 patients with non tubal factor infertility and 30 normal patients were enroled. Presence or absence of tubal factor was assessed by direct vision via laparscopy, then titres of IgA and IgG were evaluated in all of them using ELISA method in the same labratory. Data were recoded and analyzed using SPSS software and chi-square, Fisher's exact, T-test and Mann- Whitney test.Results: Positive titre of IgG was higher in tubal factor infertility but it was not statistically significant between three groups (p>0.294). Positive titres of IgA were more common in non tubal factor infertility (p=0.007). Though positive and negative titres of IgA (P=0.224) and IgG (P=0.273) were not statistically different in fertile and infertile patients. Positive and negative titres of IgA and IgG were also not statistically different in patients with or without PID (p>0.05).Conclusion: No correlation was found between the positive titres of IgG and IgA against Chlamydia and tubal factor infertility.
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