Abstract
Tubal factors are associated with infertility. To evaluate the influence of past Chlamydial infections on female fertility with unilateral tubal occlusion, we compared the cumulative pregnancy rate of Chlamydia antibody seropositive women with those who are seronegative. A retrospective, case-controlled study was designed. A total of 54 consecutive infertile women with unilateral tubal occlusion diagnosed by hysterosalpingography (HSG) during January, 2009 to April, 2013 were enrolled in this study. Each patient was followed up for three years. The study group was composed of 19 Chlamydia antibody seropositive women. The control group consisted of 35 who are seronegative. The cumulative pregnancy rate of the study group was 6/19 (31.5%) and that of the control group was 19/35 (54.3%). This suggested that the patients with past Chlamydial infections had more difficulty becoming pregnant than those without prior infections. There were no significant differences of clinical parameters between the two groups. This study suggested that past Chlamydia infection may contribute to lower pregnancy rates in infertile women with unilateral tubal occlusion. Patients with both unilateral tubal occlusion and Chlamydia antibody seropositive may do better to proceed to in vitro fertilization (IVF).
Highlights
Tubal factors are estimated to be associated with infertility in approximately 40% and 85% of infertile women in developed and developing countries, respectively [1]
There is no significant difference of age, serum level of basal LH/FSH, body mass index (BMI), Figure 1
One previous study reported that fecundity rate ratios were 0.81 (95% confidence interval 0.47 to 1.4) for a one-sided tubal occulusion and 0.30 (95% confidence interval 0.13 to 0.71) for a two-sided occulusion, so one-sided tubal pathology detected by HSG has limited prognostic significance [11]
Summary
Tubal factors are estimated to be associated with infertility in approximately 40% and 85% of infertile women in developed and developing countries, respectively [1]. Salpingitis accounts for 50% of tubal factors causing infertility [2]. It has been reported that more than a half of tubal damage is attributed to Chlamydia infection [3]. Untreated Chlamydia infections can lead to serious complications. Untreated Chlamydia infection in man can cause urethritis, epididymitis and proctitis. Up to 30% of women with untreated Chlamydia infections developed pelvic inflammatory disease (PID). Of these women, the majority had symptoms that were too mild or nonspecific to cause them to seek medical treatment. Regardless of symptom intensity, the consequences of PID are severe [4]
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