The relationship between chlamydia infection and infertility at the Lagos University Teaching Hospital, Lagos, Nigeria

Abstract

Context: Infertility affects 10–15% of couples worldwide and tubal factor is a major component in sub-Saharan Africa. Pelvic inflammatory disease due to chlamydia infection is a known risk factor for tubal infertility. Objective: This case-control study was carried out to determine the relationship between chlamydial infection and infertility as seen at the Lagos University Teaching Hospital, Lagos, Nigeria. Methodology: This was a case-controlled study of 180 participants recruited from the Gynaecology Outpatient and Family Planning Clinics of the Lagos University Teaching Hospital, Lagos, Nigeria (LUTH). The cases were 60 females diagnosed to have tubal infertility and 60 other infertile females with patent tubes. The control group comprised of 60 females attending the family planning clinic. The females were tested for serum chlamydia IgG antibody using a kit that detects serovar specific Chlamydia trachomatis antibody. Endocervical swab samples were also tested for chlamydial antigen using a kit that detects C. trachomatis genus specific lipopolysaccharide antigen. The results were collated and analyzed using the statistical package for the social sciences (SPSS) version 18. Results: All the females tested negative for chlamydia antigen. The odd ratio for having a case testing positive for chlamydial antibody compared to control was 4.0 [95% CI = 1.47–10.88]. The odd ratio for infertile females with blocked tubes compared with those who had patent tubes testing positive for chlamydia antibody was 3.52 (95% CI: 1.46–8.49). Conclusion: This study suggests an etiological relationship between chlamydial infection and infertility in general and tubal infertility in particular.