Evidence of prior pelvic inflammatory disease and its relationship toChlamydia trachomatis antibody and intrauterine contraceptive device use in infertile women

Gump, Dieter W.; Gibson, Mark; Ashikaga, Taka

doi:10.1016/0002-9378(83)91044-x

Cited by 105 publications

(29 citation statements)

References 14 publications

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“…Note that among the cases, a high proportion of the titers that would normally be considered positive (1:32 and above) are at particularly high levels. This has been observed repeatedly in similar studies of TFI (11,15,16,30,31), and PID (10,18). In other words, women at higher risk of reproductive damage are more likely to be CT antibody positive, and are more likely to have particularly high titers than antibody-positive controls.…”

supporting

confidence: 59%

“…The major studies of reproductive outcomes in women with PID (5-7) have been restricted to the small proportion of PID (8) that is diagnosed in hospital. In the 1980s and 1990s large numbers of serological case-control studies were carried out, comparing serum antibody levels in women with PID, EP or infertility, with controls (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). These studies invariably showed strong associations between detection of CT antibodies and reproductive damage, but it was difficult to draw quantitative conclusions from them, partly because of confounding between CT and other pathogens also implicated in reproductive morbidity (20), and partly because of the poor, and imprecisely known, sensitivity and specificity of the assays used (21,22).…”

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confidence: 99%

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Proportion of Tubal Factor Infertility due toChlamydia: Finite Mixture Modeling of Serum Antibody Titers

Ades¹,

Price²,

Kounali³

et al. 2017

Am. J. Epidemiol.

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms estimates based on the standard PEF formula from case-control studies were 0% and over 65%.Finite mixture modeling can be applied to serological data to obtain estimates of the proportion of reproductive damage attributable to Chlamydia trachomatis. Further studies should be undertaken using modern assays in contemporary, representative populations. <198 words>

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supporting

confidence: 59%

mentioning

confidence: 99%

Proportion of Tubal Factor Infertility due toChlamydia: Finite Mixture Modeling of Serum Antibody Titers

Ades¹,

Price²,

Kounali³

et al. 2017

Am. J. Epidemiol.

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“…It was also confirmed that assessment of the endometrium for chlamydial infection by PCR analysis is a sound medical option for selected patients with infertility [19]. Gump et al [20] studied 204 infertile patients attending an infertility clinic, and all but 1 had negative cultures for C. trachomatis in cervical and endometrial specimens. These authors have found a significant correlation between prevalence of chlamydial antibodies and prior pelvic inflammatory disease, as documented by hysterosalpingography and/or laparoscopy.…”

Section: Discussionmentioning

confidence: 90%

Detection of Chronic Endometritis by Diagnostic Hysteroscopy in Asymptomatic Infertile Patients

Polisseni

Bambirra²,

Camargos³

2003

Gynecol Obstet Invest

105

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Chronic endometritis has been related to infertility and recurrent abortion. It is usually asymptomatic, and the diagnosis is rarely clinically suspected. We performed a prospective study to evaluate both the role of diagnostic hysteroscopy in the detection of chronic endometritis in infertile patients and Chlamydia trachomatis is a potential etiologic factor. Fifty consecutive patients who sought treatment for infertility in a tertiary academic hospital were submitted to diagnostic hysteroscopy and an endometrial biopsy for histopathological study and for diagnosis of C. trachomatis by polymerase chain reaction. The patients’ mean age was 33.7 ± (SD) 5.4 years, and the duration of the couples’ infertility ranged from 1 to 18 years. The overall prevalence of chronic endometritis was 12% (6 patients). Among all patients, no cases of chlamydial infection were detected by polymerase chain reaction. In the detection of chronic endometritis, with 95% confidence intervals, the hysteroscopy sensitivity was 16.7% (range 0.9–63,5%), the specificity was 93.2% (range 80.3–98.2%), the positive predictive value was 25% (range 1.3–78.1%), and the negative predictive value was 89.1% (range 65.6–95.9%). These data suggest that hysteroscopy is not useful in the screening for chronic endometritis in asymptomatic infertile women. Further studies are needed to establish the etiology of endometritis in infertile patients.

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“…Several workers have reported failure to culture Chlamydia trachomatis from the fallopian tubes, where cervical swabs were positive and the patients had tubal factor infertility [3,5,9,20]. This suggests either technical difficulties in isolation of the Chlamydia organism, or that the tubal occlusion is a host-determined response to past infection, as is suspected for trachoma [5].…”

Section: Discussionmentioning

confidence: 99%

“…Chlamydia trachomatis has been isolated from the fallopian tubes of females with acute pelvic inflammatory disease (PID) [2], Serological studies for Chlamydia have also established a link between infection with Chlamydia and adhesion formation. High serum titers of Chlamydial antibodies have been reported in infertile women with damaged fallopian tubes [3,4]. Between 64% and 91% of infertile females with tubal occlusion had antibodies to Chlamydia, a prevalence two to eight times greater than that found in females with other causes of infertility [5].…”

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confidence: 95%

The Role of Chlamydia Trachomatis Infection in Female Infertility

Babay

Al-Meshari

1993

Ann Saudi Med

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The incidence of positive Chlamydia cultures in females undergoing laparoscopy for tubal patency is high. We advocate routine screening for Chlamydia infection in females with infertility. Of seventy-five patients undergoing laparoscopy for infertility, 49 grew Chlamydia on tissue culture of material from the cervix, an incidence of 65.3%. Of these 49 cases, 33 (67.3%) had tubal blockage. In asymptomatic patients, 22 out of 50 had positive cultures from the cervix, an incidence of 44%. Peritoneal fluid culture was negative in all infertile patients. When compared to populations studied elsewhere, the incidence of Chlamydia appears to be high in our population and significantly higher in the infertile patients. In the management of infertility, pelvic inflammatory disease, and neonatal conjunctivitis, Chlamydia should be routinely investigated and treated. Infertility is increasing in many areas of the world, including Saudi Arabia, and poses a major health problem. Tubal occlusion produced by peritubal adhesions, hydrosalpinx formation, and intraluminal adhesions is the underlying pathological abnormality in tubal infertility following acute salpingitis [1]. The risk of infertility following Chlamydia infection is still unknown. Chlamydia trachomatis has been isolated from the fallopian tubes of females with acute pelvic inflammatory disease (PID) [2], Serological studies for Chlamydia have also established a link between infection with Chlamydia and adhesion formation. High serum titers of Chlamydial antibodies have been reported in infertile women with damaged fallopian tubes [3,4]. Between 64% and 91% of infertile females with tubal occlusion had antibodies to Chlamydia, a prevalence two to eight times greater than that found in females with other causes of infertility [5].Chlamydia trachomatis was also found in cultures from the endometrium of infertile females with antiChlamydial antibodies in 26% of cases and from the endocervix in 32% [6]. However, Chlamydia trachomatis was recovered from fallopian tube biopsies in 15% of females undergoing tubal surgery for infertility, and from the endometrium in 80% of them [7].The present study was carried out with the objective to determine the prevalence of Chlamydia trachomatis in the lower genital tract of asymptomatic Saudi patients attending King Khalid University Hospital (KKUH), the prevalence of Chlamydia trachomatis in the genital tract of infertile patients, and to determine the relationship between the organism and tubal infertility. The incidence of Chlamydia trachomatis in the peritoneal fluid of infertile patients was also determined, and the usefulness of analysis of the peritoneal fluid for culture of Chlamydia trachomatis evaluated. Patients and MethodsOver a ten month period between October 1989 and July 1990, 158 consecutive females undergoing evaluation for infertility at KKUH were approached to enroll in this study. All patients were married and all were Saudis. All females were enrolled at their initial visit to the clinic if they were involunta...

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Evidence of prior pelvic inflammatory disease and its relationship toChlamydia trachomatis antibody and intrauterine contraceptive device use in infertile women

Cited by 105 publications

References 14 publications

Proportion of Tubal Factor Infertility due toChlamydia: Finite Mixture Modeling of Serum Antibody Titers

Proportion of Tubal Factor Infertility due toChlamydia: Finite Mixture Modeling of Serum Antibody Titers

Detection of Chronic Endometritis by Diagnostic Hysteroscopy in Asymptomatic Infertile Patients

The Role of Chlamydia Trachomatis Infection in Female Infertility

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