Chlamydial serology among patients with tubal factor infertility and ectopic pregnancy in Alexandria, Egypt

Abstract

Background and objectives: Little is known about the role of Chlamydia trachomatis in the etiology of tubal factor infertility and ectopic pregnancy in Egypt.

Goal of this study: To assess the association between past chlamydial infection, tubal factor infertility, and ectopic pregnancy in an Egyptian population.

Study design: This report consists of two concurrent case-control studies. First, 51 patients with tubal factor infertility were compared with 48 healthy subjects who did not have tubal factor infertility and 53 pregnant subject subjects. Second, 66 patients with ectopic pregnancy were compared with 51 pregnant control subjects.

Results: Geometric mean titers for Chlamydia trachomatis were higher among patients with tubal factor infertility and ectopic pregnancy, and they were more likely to have high antichlamydial titers (> or = 1:128 immunoglobulin G). Serum titer was significantly correlated with histologic evidence of salpingitis among the patients with an ectopic pregnancy.

Conclusion: Our findings, similar to those from Western societies, suggest that among Egyptian women, prior chlamydial infection is associated with an increased risk of tubal factor infertility and possibly ectopic pregnancy.

PIP: This paper reports findings from a study which explored the association between past chlamydial infection, tubal factor infertility, and ectopic pregnancy in an Egyptian population. Conclusions are based upon findings from two concurrent case-control studies. In the first study, 51 patients with tubal factor infertility were compared with 48 healthy subjects who did not have tubal factor infertility and 53 pregnant subjects. In the second study, 66 patients with ectopic pregnancy were compared with 51 pregnant control subjects. Women who participated in the studies were patients of mean age approximately 29 years who presented for obstetrics and gynecology services at Shatby Hospital, Alexandria, Egypt, during 1989. The hospital serves a low- to lower-middle-class population. Geometric mean titers for Chlamydia trachomatis were higher among patients with tubal factor infertility and ectopic pregnancy, and they were more likely to have high antichlamydial titers. Further, serum titer was significantly correlated with histologic evidence of salpingitis among the patients with an ectopic pregnancy. These findings suggest that among Egyptian women, prior chlamydial infection is associated with an increased risk of tubal factor infertility and possibly ectopic pregnancy.