Burden of Chlamydia trachomatis infection amongst infertile women compared with pregnant controls in North-central Nigeria

Abstract

Background: Female infertility due to tubal damage resulting from pelvic infections including Chlamydia trachomatis is common among women in our environment. The study aimed at determining the prevalence of Chlamydia trachomatis antibody amongst infertile women and to assess the relationship between exposure to Chlamydia trachomatis infection and tubal infertility in Garki Hospital, Abuja, Nigeria.Methods: This was a case control study among 76 infertile patients with tubal occlusion diagnosed with hysterosalpingography and confirmed by laparoscopy compared with 81 pregnant women recruited from the antenatal clinic. Both cases and control were investigated with a study protocol which solicited information on socio-demographic variables, sexual and reproductive risk factors and history of previous pelvic infection. Each subject and control had 5 ml of blood collected for serological assay for Chlamydial antibody titre using the immunocomb Chlamydia trachomatis 1gG kit. The data was analyzed using the SPSS version 20 (IBM, Armonk, NY, USA). A p-value of < 0.05 was considered statistically significant.Results: The prevalence of serum Chlamydial antibody was 57 (75.0%) and 19 (23.5%) among the cases and the pregnant controls respectively (P-value < 0.001). The results showed statistically significant associations between tubal infertility and early age at sexual debut, three or more sexual partners, nulliparity and positive Chlamydia trachomatis antibody titre (P-values < 0.001).Conclusions: The prevalence of Chlamydia trachomatis antibody titre was higher among women with infertility compared to the pregnant controls. The findings suggest that tubal infertility is associated with exposure to Chlamydial trachomatis infection.

Risk profile of Qatari women treated for infertility, 2018

“…They concluded that the clinical feature having the potential of identifying woman at high risk for Chlamydia infection were vaginal discharge (24.5%), followed by dysmenorrhea (24.5%) and lower abdominal pain (23.1%). (31) The present study also demonstrated that fallopian tube blockage is a risk factor for female infertility (OR=5.45, 95% CI= 1.75 -16.95, p=0.003). Fallopian tube blockage was much more common in secondary infertile females (20.4%) compared to only 9.3% of primary infertile.…”

“…(30) The present study found that symptoms suggestive of STIs were highly correlated with female infertility; dyspareunia (OR=7.04, 95% CI= 2.76 -17.95, p=0.001), while chronic lower abdominal pain or abnormal vaginal discharge increased the risk of infertility by more than three times. In Nigeria, Ogbu GI. et al (2017) studied the relationship between Chlamydia trachomatis infection and tubal infertility found a statistically significant association between positive C. trachomatis antibody titre among cases with tubal factor infertility (75.0%) compared with controls (22.2%).…”

Risk profile of Qatari women treated for infertility in a tertiary hospital: a case-control study

“…et al (2017) studied the relationship between Chlamydia trachomatis infection and tubal infertility found a statistically significant association between positive C. trachomatis antibody titre among cases with tubal factor infertility (75.0%) compared with controls (22.2%). They concluded that the clinical feature having the potential of identifying woman at high risk for Chlamydia infection were vaginal discharge (24.5%), followed by dysmenorrhea (24.5%) and lower abdominal pain (23.1%) [ 37 ]. The present study also demonstrated that fallopian tube blockage is a risk factor for female infertility (OR = 5.45, 95% CI = 1.75–16.95, p = 0.003).…”

Impact of genital Chlamydia trachomatis infection on reproductive outcomes among infertile women undergoing tubal flushing: a retrospective cohort at a fertility centre in Uganda

“…However, higher prevalence estimates have been reported among women in low resource settings with tubal factor infertility i.e. (35.3%) [8] and 75% [26]. Both studies [8,26] utilised systemic antibody against C. trachomatis proteins which are more sensitive for previous C. trachomatis exposure unlike direct local antigen tests which detect current infection.…”

“…Although several studies have linked C. trachomatis infection to infertility [5,8,26,28], there are no reports on the impact of active genital C. trachomatis infection on outcomes among women undergoing tubal flushing. This study found an association between active genital C. trachomatis infection and reduced clinical pregnancy and live birth rate among women who underwent tubal flushing.…”