In vitro fertilization outcome in women with tubal factor of infertility and previous chlamydial infection

Abstract

In order to examine the results of IVF and IVF/ICSI programs in women with tubal infertility (TFI) and previous exposure to chlamydial infection a total of 242 women were enrolled in the study. Materials and methods. Sera and follicular fluid samples were tested using EIA for antibodies to chlamydial antigens: the major outer membrane protein (MOMP - IgG, IgA) and heat shock protein chsp60 (IgG). Prevalence of antichlamydial antibodies in sera was 50,4 % (122/242), 10,7 % (26/242) and 5,8 % (14/242); in follicular fluid - 30,2 % (73/197), 3,7 % (9/197) and 4,5% (11/197) coordinaly. Patients were divided to two groups: main group (with IgG to C. trachomatis MOMP in sera, N = 122) and comparison group (absence of antibodies, N = 120). Results. The miscarriage rate after conventional IVF or IVF/ICSI cycle in main group patients was 28 % (7/30), compared to 3,3 % (1/30) in comparison group, р = 0,018. Pregnancy and live birth rate in women from main group was 40 % (22/55) and 30,9 % (17/55); in patients of comparison group - 22,2 % (16/72) and 15,3 % (11/72); р = 0,03 and р = 0,035, coordinaly. Results showed no difference in efficiency of IVF/ICSI programs for the examined groups of patients. Conclusion. Antibodies to C. trachomatis antigens are detected in blood serum of half, in follicular fluid - of every third patient with tubal factor of infertility. Serological evidence of previous exposure to chlamydial infection in these women is associated with decreased IVF success - lower pregnancy and live birth rates and higher risk of miscarriage.