[Chlamydia trachomatis and tubal obstruction sterility]

Abstract

In order to determine the importance of Chlamydia trachomatis in infertility due to tubal occlusion, the prevalence of C. trachomatis antibody was studied in two populations of Argentine women, pregnant and infertile with tubal occlusion. IgG and IgM against C. trachomatis were determined by indirect immunofluorescence in McCoy cells infected with strain L2Bu434 of C. trachomatis. In infertile women, specific anti-C. trachomatis IgM was detected in 5 out of 32 (15.6%) and IgG in 20 out of 32 (75%). In pregnant women, specific IgM was detected in 4.8% (4/83) and IgG in 20.5% (17/83). The frequency of IgG detection was significantly higher in infertile than in pregnant women (p < 0.000). Thirteen out of 20 (65%) women who underwent laparoscopic examination had evidence of chronic inflammatory disease described as yellowish viscous cysts resembling "frog eggs" in Douglas, utero and/or perihepatitis. Twelve out of fourteen (86%) infertile women with positive serology for C. trachomatis presented one or more of these laparoscopic findings. C. trachomatis antigen was detected in 2 out of 10 tubal biopsies by direct immunofluorescence with monoclonal antibodies although isolation in McCoy cells was negative. Our results show the importance of C. trachomatis in infertility due to tubal occlusion and the need of C. trachomatis diagnosis in routine gynecologic analysis to prevent infertility and neonatal infection.