Hydrosalpinx Research Articles

Isolated Fallopian Tube Torsion in Children With Hydrosalpinx: Is Conservative Management an Option?

Isolated fallopian tube torsion (IFTT) is very rare gynecological emergency in pediatric population. Our objective is to assess treatment options and discuss outcome of a cohort of IFTT with a focus on the association between IFTT and hydrosalpinx (HSX). A retrospective review was conducted. Pediatric patients with IFTT operated in the same center were included. Seventeen girls (aged: 11-16 years) were managed for acute abdominal pain between 2008 and 2018, with intraoperative diagnosis of IFTT. All patients underwent laparoscopic exploration, with laparoscopically fallopian tube detorsion in all patients. Based on the association of IFTT with HSX after fallopian tube detorsion, patients were divided into 2 groups: group 1 (IFTT without HSX; 12 girls) and group 2 (IFTT with HSX; 5 girls). During the same surgery, complementary surgical procedures were done. In group 1: salpingectomies (4), partial salpingectomies (2) and cystectomies (6) were done. In group 2: salpingectomy (1), salpingotomy (1), and cyst ablation (1). The treatment was called conservative when the tube was preserved.Follow-up was uneventful in group 1. In group 2, for all patients with initial fallopian tube preservation, further surgical procedures were necessary (1-4 surgeries/patient), and, finally, another 3 patients required salpingectomy. Conservative treatment with tube preservation of IFTT without HSX appeared to be beneficial compared to those with HSX, with no recurrence of torsion or symptoms during the follow-up. However, the same conservative treatment was not sufficiently effective for IFTT with HSX and required further procedures due to recurrence of torsion. IV.

Hydrosalpingeal fluid leads to subfertility via endometrial TNF-α and IL-7 and NF-κB signaling pathways.

To determine the concentrations of the nuclear factor kappa B (NF-κB), tumor necrosis factor-alpha (TNF-α) and interleukin-7 (IL-7) in midluteal phase endometrial samples of infertile patients diagnosed with uni or bilateral hydrosalpinx (HX). A total of 24 patients who decided to undergo laparoscopic salpingectomy were included in the study. Salpingectomy indications consisted of patients with a diagnosis of hydrosalpinx (n=12) or ectopic pregnancy (n=12). Twelve healthy patients who underwent Pomeroy-type tubal ligation were considered as the second and healthy control group. The diagnosis of hydrosalpinges was made by transvaginal 2D ultrasonography or HSG. All patients in the hydrosalpinges or ectopic pregnancy group underwent laparoscopic salpingectomy. Just before salpingectomy, endometrial samples were obtained from all patients by Pipelle cannula. Endometrial sampling was performed 7-9 days after the LH surge in the control group. IL-7, NF-κB and TNF-α concentrations were measured by ELISA method in the endometrial samples of all three groups. The endometrial IL-7 concentration before salpingectomy of the patients in the hydrosalpinx group was 44.6±6.65 ng/mg wet-tissue. The IL-7 levels of the HX group were significantly higher than those of the patients in the ectopic pregnancy group (19.3±3.06 ng/mg wet tissue versus 44.6±6.65 ng/mg wet tissue, p<0.04). Similarly, IL-7 levels of the HX group were significantly higher than those of the tubal ligation group (6.08±1.48 ng/mg wet tissue versus 44.6±6.65 ng/mg wet tissue, p<0.03). The endometrial TNF-α concentration of the patients in the hydrosalpinx group was 33.20±5.40 ng/mg wet-tissue. The TNF-α value detected in the hydrosalpinx group was significantly higher than both the TNF-α value in the ectopic pregnancy group (11.8±1.07 ng/mg wet-tissue vs. 33.20±5.40 ng/mg wet-tissue, p<0.01) and the TNF-α value in the tubal ligation group (5.30±1.22 ng/mg wet-tissue vs. 33.20±5.40 ng/mg wet-tissue, p<0.01). The pre-salpingectomy endometrial NF-κB concentration of the patients in the hydrosalpinx group was 6.38±1.40 ng/mg wet-tissue. This value is higher than endometrial NF-κB levels in the ectopic pregnancy group (3.67±0.41 ng/mg wet-tissue vs. 6.38±1.40 ng/mg wet-tissue, p<0.02) and NF-κB levels in the tubal ligation group (1.07±0.38 ng/mg wet-tissue vs. 6.38±1.40 ng/mg wet-tissue, p<0.01). The presence of hydrosalpinx prevents successful implantation by increasing the levels of endometrial proinflammatory cytokines TNF-α, IL-7 and NF-κB.

Multivariate Analysis of Recurrence after Hysteroscopic Diagnosis and Treatment of Endometrial Polyps following IVF-ET Failure.

Objective To explore the risk factors affecting the recurrence of endometrial polyps (EPs) after hysteroscopic diagnosis and treatment of EPs following in vitro fertilization-embryo transfer (IVF-ET) failure by multivariate analysis. Methods The clinical data of 369 patients with EPs hysteroscopically treated in our department due to IVF-ET failure from January 2017 to January 2020 were retrospectively analyzed, including the number and size of polyps, postoperative treatment, endometriosis (EM), hydrosalpinx (HSP), and polycystic ovarian syndrome (PCOS), and the effects of these factors on EP recurrence were observed. Results Of the patients enrolled, 184 cases (49.9%) were treated by curettage, and 185 cases (50.1%) by electrotomy. A total of 72 cases (19.5%) of postoperative recurrence were determined, including 34 cases (9.2%) without postoperative medication, 31 cases (8.4%) with one month of postoperative Didroxyprogesterone (DG) administration, and 7 cases (1.9%) with three months of postoperative DG administration. Surgical methods, 3 months of postoperative medication, PCOS, and polyp number and size significantly influence the recurrence of EPs, which were all the influencing factors of polyp recurrence. After controlling for other factors, the risk of EP recurrence after electrotomy was found to be lower than that after curettage, with an odds ratio (OR) (95% confidence interval (CI)) of 0.354 (0.163–0.767); the risk of EP recurrence after 3 months of postoperative medication was lower than that without postoperative medication, with an OR (95% CI) of 0.024 (0.005–0.104); the risk of EP recurrence in patients with PCOS was higher than that without PCOS, and the OR (95% CI) was 2.505 (1.113–5.639); patients with multiple polyps (≥2) were at an increased risk of recurrence than those with a single polyp, with an OR (95% CI) of 66.552 (14.711–301.084); patients with polyp diameter ≥ 2 cm had a higher risk of recurrence than those with polyp diameter < 2 cm, and the OR (95% CI) was 1084.76 (148.743–7910.999). Conclusions PCOS patients are at an elevated risk of EP recurrence than non-PCOS patients. In patients with multiple polyps, those with a diameter ≥ 2 cm have an increased risk of polyp recurrence compared with those with polyp diameter < 2 cm; electrotomy is associated with a lower recurrence risk of EPs than curettage. The risk of EP recurrence in patients treated with postoperative progesterone for 3 months is lower than that of patients without postoperative medication.

Pelvic Inflammatory Disease, A Perturbing Trigger to Infertility: A Systematic Review

Introduction: Pelvic inflammatory disease is the term used comprehensively for cervicitis, endometritis, salpingitis, pelvic peritonitis, and tubo-ovarian abscess. Diagnosis is initially by clinical assessment, confirmed by laboratory investigations and imaging modalities. PID is usually ignored by patients and clinicians eventually leading to infertility . Purpose: The goal of this systematic review is to evaluate co relation of PID with infertility and role of imaging modalities for diagnosis. Method: During October 2020 we searched Google scholar, pub med, Medscape research articles from 2010 -2020. Conclusion: Pelvic inflammatory disease is second most common cause of infertility while diagnostic ultrasonography plays a limited role to diagnose. Keywords: Pelvic inflammatory disease, infertility, endometritis, hydro salpinx, Tubal factor infertility and Sonographic evaluation. DOI: 10.7176/JHMN/82-08 Publication date: November 30 th 2020

Detection of Chlamydia in multiple visceral organs of mice inoculated with Chlamydia through different routes

Objective To certify that Chlamydia can spread from the genital tract to the gastrointestinal tract for long-lasting colonization. Methods Totally, 120 female C57BL/6J mice aged 5 - 6 weeks were divided into 4 experimental groups to be inoculated with purified Chlamydia muridarum (C. muridarum) elementary bodies in the vagina (n = 35) , gastric area (n = 30) , anus and rectum (n = 30) , retro-orbital venous plexus (n = 5) respectively. Moreover, corresponding negative groups inoculated with sucrose phosphate glutamate buffer (n = 5) were set up for each experimental group. On days 3, 7, and every 7 days, vaginal and rectal discharges were collected with swabs from the mice, and the number of live C. muridarum orgnisms in exfoliated cells infected with C. muridarum in the swabs was determined. Indirect immunofluorescence assay and quantitative PCR (qPCR) were performed to determine the number of live chlamydial organisms and the copy number of chlamydial genomes in the mouse genital tract (vagina, uterus, oviduct and ovary) , gastrointestinal tract (stomach, small intestine, cecum, colon, rectum) and parenteral tissues (heart, liver, spleen, lung, kidney) on days 7, 14, 28, 56 and 105 after the inoculation. The number of live chlamydial organisms and copy number of chlamydial genomes were transformed logarithmically with a base of 10. The degree of hydrosalpinx and inflammation in the genital tract, and histopathological changes of the gastrointestinal tract were observed. The infectivity and virulence of C. muridarum in the genital tract and gastrointestinal tract were evaluated in the intragastric inoculation group and intra-anal and intrarectal inoculation group on days 28 and 56 after the inoculation. Blood samples were obtained from the mouse caudal vein in the retro-orbital venous plexus inoculation group on days 3, 5, 7, 10 and 14 after the inoculation, the number of live chlamydial organisms and the copy number of chlamydial genomes in the blood samples were determined, and chlamydial infectivity in the genital tract and gastrointestinal tract was evaluated on day 56. Results On day 7 after the inoculation in the vagina, both C. muridarum live organisms and genomes were detected in the genital tract, gastrointestinal tract and parenteral tissues of all the mice. The largest common logarithm of the number of C. muridarum inclusion forming units (IFU) was observed in the vagina (6.26 ± 0.56) , with the common logarithm of the copy number of chlamydial genomes in the vagina being 7.30 ± 0.23, and the common logarithms of the number of Chlamydia IFU and genomic copy were 2.60 ± 1.95 and 4.87 ± 0.09 respectively in the rectum. On day 28, no live Chlamydia was detected in the heart, lung or other parenteral tissues, while live Chlamydia could be found in the genital tract and gastrointestinal tract. The common logarithms of the number of Chlamydia IFU and genomic copy were 3.47 ± 1.06 and 5.80 ± 1.49 respectively in the vagina, and 4.00 ± 0.35 and 5.14 ± 0.81 respectively in the rectum. On day 56, live Chlamydia could only be detected in the gastrointestinal tract. On day 105, live Chlamydia and its genomes could be still detected in the gastrointestinal tract, and the common logarithms of the number of Chlamydia IFU and genomic copy could be up to 2.60 ± 0.65 and 4.29 ± 0.57 respectively in the rectum. On days 28 and 56 after the inoculation, both live Chlamydia and its genomes could be detected in the gastrointestinal tract of all the mice in the intragastric inoculation group and intra-anal and intrarectal inoculation group. Chlamydia could survive in the blood for about 14 days in the retro-orbital venous plexus inoculation group, and live Chlamydia was detected in anal-rectal swabs in all the mice on day 14. On day 56 after the intravaginal inoculation with C. muridarum, severe hydrosalpinx, chronic inflammation and oviduct dilation occurred in the genital tract of 5 mice, but there was no obvious infiltration of inflammatory cells in the gastrointestinal tract, and inflammatory pathological changes were not observed in the gastrointestinal tract of mice after inoculation with Chlamydia through other routes either. Conclusion The infection with Chlamydia in the genital tract can lead to systemic dissemination, and Chlamydia can be spread to the gastrointestinal tract, and colonize and survive in the gastrointestinal tract for a long time. Key words: Chlamydia infections; Chlamydia trachomatis; Chlamydia muridarum; Gastrointestinal tract; Reproductive tract infections; Colonization

The "cogwheel" sign of hydrosalpinx.

The "cogwheel" sign of hydrosalpinx.

Hydrosalpinx and IVF: Effect and Management

Hydrosalpinx and IVF: Effect and Management

Hysteroscopic Placement of Platinum Microinsert in Patients With Hydrosalpinx Before In Vitro Fertilization and Embryo Transfer

To investigate the effectiveness of Tornado and Hilal (Cook Medical, Bloomington, IN) hysteroscopic proximal tubal occlusion (HPTO) for hydrosalpinx (HX) treatment before in vitro fertilization (IVF) and embryo transfer (ET) in patients with dense pelvic adhesions or low ovarian reserve. A retrospective study of patients treated between May 2014 and May 2016 (Canadian Task Force classification III). A university-affiliated center. One hundred fifty women with unilateral or bilateral HX who were not candidates for laparoscopic surgery. Tornado or Hilal HPTO before IVF-ET and/or frozen ET. The main outcome was the cumulative live birth rate. Tornado or Hilal placement was successful for 143 (95.3%) patients. Of the 132 patients who underwent 204 ET cycles, 86 (65.2%) conceived, and 78 (59.1%) resulted in live births. The overall early and late miscarriage rates per clinical pregnancy were 12.8% and 1.1%, respectively. The ectopic pregnancy rate was 2.3%. No major complications occurred. Tornado or Hilal HPTO is an effective alternative for treating HX before IVF-ET/frozen ET in patients with dense pelvic adhesions or low ovarian reserve.

A Case of Ovarian Glomus Tumor and Literature Review

A 42-year-old Chinese female presented with postcoital bleeding and was incidentally found to have a complex mass in the left adnexal region on pelvic ultrasound. A laparoscopic left salpingo-oophorectomy performed showed an 8 cm cystic mass arising from the left ovary with an associated left fallopian tube hydrosalpinx. The mass was composed of epithelioid cells with a vague nested architecture which showed positive smooth muscle actin (SMA) immunohistochemical staining. Features were consistent with a glomus tumor, an extremely rare mesenchymal neoplasm arising in the ovary. Our case is hitherto the largest reported glomus cell tumor of the ovary measuring 8 cm to date. This tumor has uncertain malignant potential requiring close gynecological surveillance. J Med Cases. 2018;9(3):83-85 doi: https://doi.org/10.14740/jmc2998w

Erratum to "Torsion of Hydrosalpinx with Concurrent Acute Cholecystitis: Case Report and Review of Literature".

[This corrects the article DOI: 10.1155/2016/5424092.].

Non-Sexually Transmitted Pyosalpinx in an Adolescent

Non-Sexually Transmitted Pyosalpinx in an Adolescent

EP26.07: Hydrosalpinx abruptly turned into hematosalpinx immediately after menstruation

EP26.07: Hydrosalpinx abruptly turned into hematosalpinx immediately after menstruation

Pregnancy outcome of in vitro fertilization after Essure and laparoscopic management of hydrosalpinx: a systematic review and meta-analysis

To assess and compare pregnancy outcomes in hydrosalpinx (HX) patients treated by Essure, laparoscopic salpingectomy, and proximal tubal occlusion (LPTO) before IVF. Systematic review and meta-analysis. University-affiliated teaching hospital. Women undergoing Essure, laparoscopic salpingectomy, and LPTO for HX before IVF. The overall combined risk estimates were calculated by means of fixed- or random-effects models. Clinical pregnancy rate (CPR) and live birth rate (LBR). In total, 3,065 patients were included in 33 studies. Thirteen of them were comparative studies among 3 surgical methods and no intervention. In the analysis of comparative studies, there were no significant differences in implantation rate (IR), CPR, and ongoing pregnancy rate/LBR between salpingectomy and LPTO groups. The CPR, IR, and LBR of Essure were significantly lower than those of the laparoscopic surgery (salpingectomy and LPTO) group, with a CPR of 34.1% vs. 44.0% (relative risk [RR] 0.71; 95% confidence interval [CI] [0.51, 0.98]), an IR of 17.3% vs. 38.0% (RR 0.45; 95% CI [0.27, 0.74]), and an LBR of 22.2% vs. 37.4% (RR 0.57; 95% CI [0.35, 0.91]). Management of HX by laparoscopic salpingectomy and LPTO yielded the same effect on the improvement of the pregnancy outcome after IVF. The hysteroscopic placement of Essure devices to treat HX before IVF produces inferior pregnancy outcomes compared with those following the laparoscopic approach. More multicenter randomized, controlled trials are warranted in future research to further examine the conclusion from this meta-analysis.

Abnormal Hysterosalpingographic Findings in Infertile Women

Objective: to determine the rate and patterns of hysterosalpingography (HSG) abnormality among infertile women at Srinagarind Hospital, Khon Kean University, Thailand. Materials and methods: The study patients were identified through the reports of the Infertile Clinic. In our hospital, HSG was routinely performed in all women undergoing an evaluation of infertility problems. Medical records were abstracted for baseline characteristics, types of infertility, and details of HSG findings. A 95% confidence interval (CI) was calculated to demonstrate the precision of data. Logistic regression model was used to determine an independent impact of the type of infertility on abnormal HSG findings. Results: Overall, 589 women were reviewed. The mean ± SD age was 32.9 ± 5.0 years. Secondary infertility was noted in 163 (27.7%) women. Abnormal HSG was noted in 227 (38.5%, 95% CI, 34.6%-42.6%) women. The most common abnormal HSG findings were tubal occlusion and hydrosalpinx. When adjusted with patients’ age, women with secondary infertility carried a higher risk of having abnormal HSG finding compared to those with primary infertility (an adjusted odds ratio, 2.44; 95% CI, 1.68-3.54). Conclusion: Rate of abnormal HSG findings among infertile women in our setting was approximately 40%. Type of infertility was independently associated with abnormal HSG findings.

Essure a novel option for the treatment of hydrosalpinx: a case series and literature review

Objective: The aim of this study is to evaluate the use of hysteroscopic Essure device placement for the treatment of hydrosalpinx (HS)-related infertility in patients with laparoscopic contraindications and compared their pregnancy outcomes following IVF–ICSI treatment with those patients having had laparoscopic tubal occlusion (LTO).Patients: From 2008 to 2014 a total of 50 patients were diagnosed with unilateral or bilateral hydrosalpinges: 29 patients had laparoscopic contraindications and were treated hysteroscopically and 21 patients were treated with laparoscopical salpingectomy.Results: Of the 29 patients who underwent treatment with Essure®, 21 began a cycle of in vitro fertilization (IVF), and 13 finished in embryo transfer that resulted in seven clinical pregnancies. Furthermore, in the group of women treated with salpingectomy, 17 started an IVF cycle that resulted in 12 clinical pregnancies. The clinical pregnancy rate per patient with an IVF cycle started was 33.3% and 70.6%, the live-birth rate per patient was 14.3% and 52.9%, the miscarriage rate was 57.1% and 18.2%, and the implantation rate was 16.3% and 34.1% for hysteroscopy and laparoscopy, respectively.Conclusion: Essure® placement is an alternative method for occlusion of hydrosalpinges before IVF. Monitoring the live-birth rate confirms that this option may be considered when laparoscopy is impossible or contraindicated.

Effect of different laparoscopic procedures for hydrosalpinx on pregnancy outcome of embryo transfer

To explore the effects of different laparoscopic procedures before embryo transfer (ET) for hydrosalpinx on pregnancy outcomes. Group A (n = 269) underwent laparoscopic bilateral salpingectomy before ET while group B (n = 178) had laparoscopic bilateral tubal salpingostomy for hydrosalpinx. And the pregnancy outcomes of ET were evaluated. The implantation, pregnancy, abortion, ectopic pregnancy and live birth rates were similar in 2 groups (P > 0.05). The interstitial pregnancy rate was 10.27% after bilateral salpingectomy. The clinical pregnancy rate increased while the interstitial pregnancy rate decreased when the intervals between salpingectomy and ET were prolonged. But there was no statistical significance (P > 0.05). Laparoscopic tubal salpingostomy is as effective as salpingectomy for hydrosalpinx before ET. The interstitial pregnancy rate increases after laparoscopic salpingectomy. The interval between salpingectomy and ET should be appropriately scheduled.

Isolated fallopian tube torsion: A rare case

Abstract Isolated fallopian tube torsion is an uncommon cause of acute low abdominal pain in women. We present a case of 18-year-old virgin girl with isolated right fallopian tube torsion. She was admitted to the Emergency Department of our hospital with abdominal pain. Pelvic ultrasound revealed bilateral enlarged ovaries containig 4 cm and 3 cm cystic masses and some free fluid in the pouch of Douglas. An urgent laparoscopy was performed by a general surgeon. They revealed a dusky blue twisted right hydrosalpinx with a twist of the long axis of a necrotic right fallopian tube. Laparotomy was performed due to restrictions of laparoscopy in detorsion of the pelvic mass. A right salpingectomy was performed subsequently. In conclusion; surgical treatment should not be delayed for salvage the tube and preserve fertility in suspicion of tubal torsion. Keywords: Abdominal pain, fallopian tube, laparoscopy, salpingectomy

Analysis of the effect of laparoscopic salpingostomy in the treatment of infertile caused by hydrosalpinx

Objective To analyze the effect of laparoscopic salpingo.stomy in the treatment of infertile caused by hydrosalpinx,and explore the reasonable treatment method for improving pregancy rate.Methods 130 infertile women with hydrosalpinx were treated with salpingostomy firstly,some unsuccessful cases were treated with salpingectomy.The pregnancy rate between successfully salpingostomied patients and unsuccessfully salpingostomied patients was also compared.Results 85 cases were salpingostomied successfully,the successful rate was 65.4％,among these patients 40 received IVF-ET,there was no difference in the natural pregnancy rate between singly hydrosalpinx (17.9％) and double hydrosalpinx(16.7％) (x2 =0.06,P ＞ 0.05),but the artificial pregnancy rate in single hydrosalpinx(70.0％) was higher than double hydrosalpinx (35.0％) (x2 =4.912,P ＜ 0.05).Among 45 unsuccessfully salpingostomied patients,14 cases underwent salpingectomy,all patients received more than two times of IVF-ET treatment,the pregnancy rate in salpingectomied patients (21.4％) was higher than unsalpingectomied (3.2％) (x2 =3.946,P ＜ 0.05).The artificial pregnancy rate of successfully salpingostomied patients (52.2％) was higher than unsuccessful patients (21.4％) (x2 =4.055,P ＜ 0.05).Conclusion Salpingostomy can raise the pregnancy rate (natural or artificial),it is beneficial to do salpingectomy for unsuccessfully salpingostomied patients who want to receive IVF-ET. Key words: Laparoscopy; Salpingostomy; Fallopian tube diseases; Infertility, female

Value and limitation of interventional recanalization for infertility induced by fallopian tube obstruction

Objective To explore the value and limitation of interventional recanalization for infertility induced by fallopian tube obstruction.Methods The X-ray appearances and clinical efficacies of hysterosalpingography and interventional recanalization for infertility induced by fallopian tube obstruction in 160 patients were retrospectively analyzed.Results Of the 160 patients,72 patients had bilateral tubal obstruction and 88 had unilateral obstruction,accounting for 45.0% and 55.0%,respectively.232 of the 320 fallopian tubes showed different degrees of obstruction; 105 tubes （45.3%） occurred interstitial obstruction,70 （30.2%） occurred isthmus obstruction,22 （9.5%） developed ampullary obstruction,and 35 （15.1%） developed umbrella end obstruction （some with hydrosalpinx）.Recanalization was successful in 197 tubes,with a total recanalization rate of 85.0%; 98 of which were successful for interstitial recanalization,with a rate of 93.3%,65 were successful for isthmus recanalization,with a rate of 92.9%,19 were successful for ampullary recanalization,with a rate of 86.4%,and 15 were successful for fimbria recanalization,with a rate of 42.9%.During the period of one-year follow-up,64 were pregnant,with a pregnancy rate of 40.0%; 9 developoed ectopic pregnancy after recanalization,with a rate of 5.6%.40 fallopian tube re-obsturcted,with a rate of 20.3%.Conclusions Interventional recanalization is an effective method for obstructive infertility induced by the three segment （interstitial,isthmus,and pot belly） obstruction of the fallopian tube; but it is not suitable for umbrella end obstruction complicated by hydrosalpinx. Key words: Interventional recanalization; Fallopian tube obstruction; Infertility; Value and limitation

Preliminary study on genital tract immune injury in mice induced by pORF5 plasmid protein of Chlamydia trachomatis

Objective To investigate the immune injury in genital tract of BALB/c mice induced by plasmid protein pORF5 of Chlamydia trachomatis and its possible mechanism.Methods GST(glutathione-S-transferases)-pORF5 fusion protein was expressed and digested with PreScission Protease to obtain the target protein without GST tag.After further purification and endotoxin removal,pORF5 protein was injected into the posterior fornix of BALB/c mice on day 1,3 and 6,while the control groups were injected with PBS or GST protein respectively,and then all the mice were sacrificed on day 7 to evaluate genital tract gross pathology and histopathological characterization.The levels of TNF-α,IL-1β and IL-6 in serum,splenocytes culture supernatant and vaginal douche were detected by ELISA.Results Mice in pORF5 group developed different degrees of swelling in isthmic portion and ampulla of uterine tube,connective tissue adhesion and hydrosalpinx in the genital tract tissues,while the PBS group and the GST group did not show any obvious change.The inflammatory score showed that the genital tract pathology in pORF5 group was much more severe than PBS and GST control groups (P＜0.O1).The levels of TNF-α,IL-1β and IL-6 in vaginal douche and splenocytes culture supernatants in pORF5 group were obviously higher than those of PBS and GST groups (P＜0.05).The levels of TNF-α and IL-1β in serum were also higher than those of GST and PBS groups (P＜0.01).Conclusion pORF5 plasmid protein could induce pathological immune response in the genital tract of BALB/c mice,which may be associated with the increase of the production of the inflammatory cytokines TNF-α,IL-1β and IL-6 in BALB/c mice. Key words: Chlamydia trachomatis; pORF5 plasmid protein; Immune injury; Cytokine