Relationship beween serum chlamydia trachomatis antibody and tubal damage in infertile women

Abstract

OBJECTIVE: To investigate the relationship between serum Chlamydia trachomatis(CT) antibody (IgA and IgG) and tubal damage in infertile women. And to assess the pregnancy rate according to the positivity of CT antibodies.DESIGN: Retrospective study.MATERIALS AND METHODS: A total of 242 patients were detected serum Chlamydia trachomatis antibody IgA and IgG. And were assessed tubal patency examined by hysterosalpingograpy (HSG) and hysteroscope between April 2005 and May 2007. Positivity and titers of CT antibody was evaluated by EIA. Positivity of the antibody was defined as over 0.9 C.I. The patients were classified 3 groups according to positivity of antibody as follows retrospectively; Group-1 was the patients detected CT antibody IgA(+)and IgG(-), n=35; Group-2 was CT IgA(+)andIgG(+), n=111; Group-3 was CT IgA(-) and IgG(+), n=96. Mean age and mean infertility periods were similar with the 3 groups. After assessment period, 55 patients were underwent assisted reproductive technology(ART) and 25 patients were performed by Fallopian tuboplasty(FT).RESULTS: CT antigen was detected 0(0%) of 35 in the Group-1, 13(11.7%) of 111 in the Group-2 and 1(1.0%) of 96 in the Group-3. The damage of tubal patency was confirmed by HSG highly in the Group-2(68.5%) and Group-3(75%). And bilateral occlusion was significantly detected higher in Group-3 than Group-1 and Group-2 (p<0.01). Hydrosalpings were detected 4(12.6%) of 111 in Group-2 and 13(13.5%) of 96 in Group-3. Hydrosalpings was not seen in the Group-1. The clinical pregnancy rate was 19(54.2%) of 35 in the Group-1, 37(33.3%) of 111 in the Group -2 and 26(27.1%) of 96 in the group-3, respectively (p<0.05, Group-1 vs Group-2; p<0.01, Group-1 vs Group-3). The pregnancy rate with standard infetility treatment including IUI and falloposcopic tuboplasty was higher in Group-1 than that in Group-2 and Group-3. The PR with ART was 3(100%) of 3, 22(73.3%) of 30 and 14(70%) of 20, respectively.CONCLUSIONS: CT antibody was detected highly in patients despite who had not been identified CT antigen. There was strong association between the positivity of CT IgG antibody and the risk of tubal damage (i.e. bilateral tubal occlusion and hydrosalpings). OBJECTIVE: To investigate the relationship between serum Chlamydia trachomatis(CT) antibody (IgA and IgG) and tubal damage in infertile women. And to assess the pregnancy rate according to the positivity of CT antibodies. DESIGN: Retrospective study. MATERIALS AND METHODS: A total of 242 patients were detected serum Chlamydia trachomatis antibody IgA and IgG. And were assessed tubal patency examined by hysterosalpingograpy (HSG) and hysteroscope between April 2005 and May 2007. Positivity and titers of CT antibody was evaluated by EIA. Positivity of the antibody was defined as over 0.9 C.I. The patients were classified 3 groups according to positivity of antibody as follows retrospectively; Group-1 was the patients detected CT antibody IgA(+)and IgG(-), n=35; Group-2 was CT IgA(+)andIgG(+), n=111; Group-3 was CT IgA(-) and IgG(+), n=96. Mean age and mean infertility periods were similar with the 3 groups. After assessment period, 55 patients were underwent assisted reproductive technology(ART) and 25 patients were performed by Fallopian tuboplasty(FT). RESULTS: CT antigen was detected 0(0%) of 35 in the Group-1, 13(11.7%) of 111 in the Group-2 and 1(1.0%) of 96 in the Group-3. The damage of tubal patency was confirmed by HSG highly in the Group-2(68.5%) and Group-3(75%). And bilateral occlusion was significantly detected higher in Group-3 than Group-1 and Group-2 (p<0.01). Hydrosalpings were detected 4(12.6%) of 111 in Group-2 and 13(13.5%) of 96 in Group-3. Hydrosalpings was not seen in the Group-1. The clinical pregnancy rate was 19(54.2%) of 35 in the Group-1, 37(33.3%) of 111 in the Group -2 and 26(27.1%) of 96 in the group-3, respectively (p<0.05, Group-1 vs Group-2; p<0.01, Group-1 vs Group-3). The pregnancy rate with standard infetility treatment including IUI and falloposcopic tuboplasty was higher in Group-1 than that in Group-2 and Group-3. The PR with ART was 3(100%) of 3, 22(73.3%) of 30 and 14(70%) of 20, respectively. CONCLUSIONS: CT antibody was detected highly in patients despite who had not been identified CT antigen. There was strong association between the positivity of CT IgG antibody and the risk of tubal damage (i.e. bilateral tubal occlusion and hydrosalpings).