Randomized Controlled Trial

. 2015 Dec;104(6):1522-6.

doi: 10.1016/j.fertnstert.2015.08.022. Epub 2015 Sep 25.

Chlamydia trachomatis immunoglobulin G3 seropositivity is a predictor of reproductive outcomes in infertile women with patent fallopian tubes

Collaborators, Affiliations

Collaborators

Reproductive Medicine Network:
C Bartlebaugh, W Dodson, S Estes, C Gnatuk, R Ladda, J Ober, R Brzyski, C Easton, A Hernandez, M Leija, D Pierce, R Robinson, J Ager, A Awonuga, L Cedo, A Cline, K Collins, S Krawetz, E Puscheck, M Singh, M Yoscovits, C Coutifaris, K Lecks, L Martino, R Marunich, A Comfort, M Crow, A Hohmann, S Mallette, Y Smith, J Randolph, S Fisseha, D Ohl, M Ringbloom, J Tang, W Bates, S Mason, L B Craig, C Zornes, M R Rodriguez, T S Hunt, N DiMaria, R Usadi, S Lucidi, M Rhea, V Baker, K Turner, M Brennan, D DelBasso, H Huang, Y Jin, Y Li, H Kuang, R Makuch, P Patrizio, L Sakai, L Scahill, C Song, H Taylor, T Thomas, S Tsang, Q Yan, M Zhang, D Haisenleder, J Trussell, B Laylor, L Martinez, A Solnica, A Wojtczuk, A Seungdamrong, M Rosen, C Lamar, L DePaolo, D Guzick, A Herring, J Bruce Redmond, M Thomas, P Turek, J Wactawski-Wende, R Rebar, P Cato, V Dukic, V Lewis, P Schlegel, F Witter

Affiliations

¹ Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina. Electronic address: asteiner@med.unc.edu.
² Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan; Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, Georgia.
³ Department of Obstetrics and Gynecology, Penn State University, Hershey, Pennsylvania.
⁴ Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado.
⁵ Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.
⁶ Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont.
⁷ Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
⁸ Department of Obstetrics and Gynecology, University of Oklahoma, Oklahoma City, Oklahoma.
⁹ Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
¹⁰ Department of Biostatistics, Yale University, New Haven, Connecticut.
¹¹ Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.

PMID: 26413816
PMCID: PMC4663111
DOI: 10.1016/j.fertnstert.2015.08.022

Randomized Controlled Trial

Chlamydia trachomatis immunoglobulin G3 seropositivity is a predictor of reproductive outcomes in infertile women with patent fallopian tubes

Anne Z Steiner et al. Fertil Steril. 2015 Dec.

. 2015 Dec;104(6):1522-6.

doi: 10.1016/j.fertnstert.2015.08.022. Epub 2015 Sep 25.

Authors

Collaborators

Reproductive Medicine Network:
C Bartlebaugh, W Dodson, S Estes, C Gnatuk, R Ladda, J Ober, R Brzyski, C Easton, A Hernandez, M Leija, D Pierce, R Robinson, J Ager, A Awonuga, L Cedo, A Cline, K Collins, S Krawetz, E Puscheck, M Singh, M Yoscovits, C Coutifaris, K Lecks, L Martino, R Marunich, A Comfort, M Crow, A Hohmann, S Mallette, Y Smith, J Randolph, S Fisseha, D Ohl, M Ringbloom, J Tang, W Bates, S Mason, L B Craig, C Zornes, M R Rodriguez, T S Hunt, N DiMaria, R Usadi, S Lucidi, M Rhea, V Baker, K Turner, M Brennan, D DelBasso, H Huang, Y Jin, Y Li, H Kuang, R Makuch, P Patrizio, L Sakai, L Scahill, C Song, H Taylor, T Thomas, S Tsang, Q Yan, M Zhang, D Haisenleder, J Trussell, B Laylor, L Martinez, A Solnica, A Wojtczuk, A Seungdamrong, M Rosen, C Lamar, L DePaolo, D Guzick, A Herring, J Bruce Redmond, M Thomas, P Turek, J Wactawski-Wende, R Rebar, P Cato, V Dukic, V Lewis, P Schlegel, F Witter

Affiliations

¹ Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina. Electronic address: asteiner@med.unc.edu.
² Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan; Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, Georgia.
³ Department of Obstetrics and Gynecology, Penn State University, Hershey, Pennsylvania.
⁴ Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado.
⁵ Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.
⁶ Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont.
⁷ Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
⁸ Department of Obstetrics and Gynecology, University of Oklahoma, Oklahoma City, Oklahoma.
⁹ Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
¹⁰ Department of Biostatistics, Yale University, New Haven, Connecticut.
¹¹ Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.

PMID: 26413816
PMCID: PMC4663111
DOI: 10.1016/j.fertnstert.2015.08.022

Abstract

Objective: To determine if Chlamydia trachomatis (C. trachomatis) seropositivity, as detected by the C. trachomatis elementary body (EB)-based enzyme-linked immunosorbent assay [EB ELISA] predicts pregnancy and pregnancy outcome among infertile women with documented tubal patency.

Design: Cohort study.

Setting: Outpatient clinics.

Patient(s): In all, 1,250 infertile women with documented tubal patency enrolled in 1 of 2 randomized controlled trials: Pregnancy in Polycystic Ovary Syndrome II; and the Assessment of Multiple Intrauterine Gestations From Ovarian Stimulation.

Intervention(s): Sera were analyzed for anti-C. trachomatis immunoglobulin G (IgG)1 and IgG3 antibodies, using a research C. trachomatis EB ELISA. The optical density (OD)405 readings of ≥ 0.35 and ≥ 0.1 were considered positive for IgG1 and IgG3, respectively.

Main outcome measure(s): Primary outcomes included pregnancy, live birth, and ectopic pregnancy. Log-linear regression was used to determine the relative risk after adjusting for age, race, treatment medication, smoking status, and current alcohol use.

Result(s): A total of 243 (19%) women were seropositive for anti-C. trachomatis IgG3. They tended to be nonwhite and smokers. Anti-C. trachomatis IgG3 seropositive women were significantly less likely to conceive (risk ratio [RR] 0.65, 95% confidence interval [CI] 0.52-0.83) or to have a live birth (RR 0.59, 95% CI 0.43-0.80); these associations were weakened after adjusting for number of hysterosalpingography-documented patent tubes (RR 0.73, 95% CI 0.56-0.97) and (RR 0.73, 95% CI 0.50-1.04), respectively. Anti-C. trachomatis IgG3 seropositive women who conceived had a ×2.7 risk (95% CI 1.40-5.34) of ectopic pregnancy.

Conclusion(s): Even in the presence of tubal patency, anti-C. trachomatis IgG3 seropositivity is associated with a lower likelihood of pregnancy. Anti-C. trachomatis IgG3 seropositive women have as high as 3 times the risk of ectopic pregnancy.

Clinical trial registration number: PPCOSII: NCT00719186 and AMIGOS: NCT01044862.

Keywords: Chlamydia trachomatis; ectopic pregnancy; infertility; pregnancy.

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Conflict of interest statement

Disclosures: Please see conflict of interest forms.

Comment in

Expanding the scope of the basic infertility workup.
Feinberg EC. Feinberg EC. Fertil Steril. 2015 Dec;104(6):1379. doi: 10.1016/j.fertnstert.2015.09.010. Epub 2015 Oct 9. Fertil Steril. 2015. PMID: 26453268 No abstract available.

References

1. Miller JH, Weinberg RK, Canino NL, Klein NA, Soules MR. The pattern of infertility diagnoses in women of advanced reproductive age. Am J Obstet Gynecol. 1999;181:952–7. - PubMed
1. Westrom LV. Sexually transmitted diseases and infertility. Sex Transm Dis. 1994;21:S32–7. - PubMed
1. Akande VA, Hunt LP, Cahill DJ, Caul EO, Ford WC, Jenkins JM. Tubal damage in infertile women: prediction using chlamydia serology. Hum Reprod. 2003;18:1841–7. - PubMed
1. Broeze KA, Opmeer BC, Coppus SF, Van Geloven N, Alves MF, Anestad G, et al. Chlamydia antibody testing and diagnosing tubal pathology in subfertile women: an individual patient data meta-analysis. Hum Reprod Update. 2011;17:301–10. - PubMed
1. Coppus SF, Opmeer BC, Logan S, van der Veen F, Bhattacharya S, Mol BW. The predictive value of medical history taking and Chlamydia IgG ELISA antibody testing (CAT) in the selection of subfertile women for diagnostic laparoscopy: a clinical prediction model approach. Hum Reprod. 2007;22:1353–8. - PubMed

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Chlamydia trachomatis immunoglobulin G3 seropositivity is a predictor of reproductive outcomes in infertile women with patent fallopian tubes

Collaborators

Affiliations

Chlamydia trachomatis immunoglobulin G3 seropositivity is a predictor of reproductive outcomes in infertile women with patent fallopian tubes

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Comment in

References

Publication types

MeSH terms

Substances

Associated data

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical