Abstract
Objective:To assess the association between positive Chlamydia trachomatis (C. trachomatis) serology and unilateral or bilateral tubal obstruction.Methods: This was a cross sectional study that evaluated the association of positive C. trachomatis serology (Immunofluorescence Indirect Serology, IIF or Enzyme Immune Essay, EIE), in two infertile groups: A. 243 patients (27 with unilateral obstruction and 216 without it). B. 247 patients (31 with bilateral obstruction and 216 without it). The exclusion criteria were tubal ligation (tubectomy) and tubal surgery. The statistical test (SPSS 17.0) was the Chi-Square with a p=5%. Tubal obstruction was diagnosed through hysterosalpingography (HSG).Results:The mean age of the patients without obstruction was 33.6 years, SD 4.9. The mean age of the patients with unilateral obstruction was 33.7 years SD 4.9. The mean age of the patients with bilateral obstruction was 33.6 years, SD 4.9. There was no statistically significant difference between the age groups. In group A (unilateral obstruction versus serology) the Chi-Square was 0.02 (p=n.s.) and the Attributable Risk (AR) = 0.7%. In Group B (bilateral obstruction versus serology) the Chi-Square test was 9.87 (p<0.005) and the AR = 14.8%.Conclusion:This study found a strong and statistically significant association between bilateral tubal obstruction and C. trachomatis positive serology. The power of the test was 86%. There was no association between unilateral obstruction and positive serology.
Highlights
Chlamydia trachomatis infection is one of the most common sexually transmitted bacterial diseases, in women (WHO, 2001)
There was no association between unilateral obstruction and positive serology
In Group B the Chi-Square test was 9.87 (p
Summary
Chlamydia trachomatis infection is one of the most common sexually transmitted bacterial diseases, in women (WHO, 2001). In Sweden, the incidence of Chlamydia infection increased from 171.7 to 406.2 cases per 100,000 between 1998 and 2009 (Sylvan & Christenson, 2008; Christenson & Sylvan, 2011). According to the World Health Organization, 10%40% women with untreated or repeated infections develop symptomatic pelvic inflammatory disease (WHO, 2016), which results in scarring and fibrosis of the Fallopian tubes (Hillis et al, 1997) and can lead to ectopic pregnancy (Chow et al, 1990). 30%-40% of cases of female infertility are caused by postinfectious tubal damage resulting in hydrosalpinx (Brunham & Rey-Ladino, 2005; WHO, 2016). Chlamydia infection treatment does not always prevent progressive tubal damage (Brunham & Rey-Ladino, 2005)
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