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CORRESPONDENCE
Year : 2015  |  Volume : 33  |  Issue : 2  |  Page : 331-332
 

Seroprevalence of chlamydia trachomatis in infertile women in a tertiary care hospital: A pilot study


1 Department of Microbiology, Gauhati Medical College and Hospital, Guwahati, Assam, India
2 Department of Microbiology, Silchar Medical College and Hospital, Silchar, Assam, India

Date of Submission19-Aug-2013
Date of Acceptance19-Jul-2014
Date of Web Publication10-Apr-2015

Correspondence Address:
D G Mohan
Department of Microbiology, Gauhati Medical College and Hospital, Guwahati, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.154902

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How to cite this article:
Mohan D G, Borthakur A K. Seroprevalence of chlamydia trachomatis in infertile women in a tertiary care hospital: A pilot study. Indian J Med Microbiol 2015;33:331-2

How to cite this URL:
Mohan D G, Borthakur A K. Seroprevalence of chlamydia trachomatis in infertile women in a tertiary care hospital: A pilot study. Indian J Med Microbiol [serial online] 2015 [cited 2019 Sep 18];33:331-2. Available from: http://www.ijmm.org/text.asp?2015/33/2/331/154902


Dear Editor,

Genital infections caused by Chlamydia trachomatis is one of the most common sexually transmitted diseases (STDs) among general population. Women are infected more often than men, remain asymptomatic and suffer the most serious consequences of genital chlamydial infections like tubal infertility, ectopic pregnancy and the chronic pelvic pain syndrome. [1] In developed countries, infertility affects approximately 1 in 6 couples, with tubal occlusion being a factor in 10-30%. [2] Most women with infertility due to tubular disease do not have a prior history of STD disease or pelvic inflammatory disease (PID). However, a strong association between tubal infertility, serologic evidence of prior chlamydial infection has been a consistent observation, in multiple studies. [3] Practical observations suggest that rapid, highly sensitive, but less specific chlamydial antibody tests are most suitable for screening, limiting the use of labour-intensive and specific chlamydial antibody tests to those with a positive screen. [4]

The prospective study was carried out for a period of one year in a tertiary care hospital, Assam, which comprised of 80 cases, who were screened for IgG antibodies against C. trachomatis. The study group comprised of 40 selected women comprising both primary and secondary infertility cases excluding the male factors and congenital defects of genitourinary tract. Women who had history of antibiotic treatment in the previous two months were excluded from the study. The women who had normal Mantoux test, normal chest X-ray finding and previously not diagnosed as other STDs were included in the study. Tubal blockage was confirmed by both hysterosalpingography and laparoscopy. Control group comprised of 40 fertile women. Serum samples were collected from all the patients and tested for chlamydial IgG antibody using the CaptiaTM Chalmydia IgG ELISA kit (Trinity Biotech, USA) and for syphilis using Rapid Plasma Reagin Test (RPR). The patient's immune status ratio (ISR) was interpreted according to the kit and the significance of prevalence was tested by Chi-square test by applying various degrees of freedom and from probability tables of Chi square.

The prevalence of C. trachomatis infection in the study group was 25%, as 10 out of 40 cases were seropositive for chlamydia IgG. In the control group, seropositivity for Chlamydia IgG was 7.5%. The study group comprised of 24 primary infertility and 16 secondary infertility cases. Of these, 16.6% primary infertility and 37.5% secondary infertility cases were found to be positive for Chlamydia IgG antibody. Also it was found that seropositivity for Chlamydia IgG in case of tubal blockage was 60% and in patent tube was 20%, which correlates the other studies from India as well. [5],[6] Other relevant factors like age of the women, age at first sexual contact, H/O oral contraceptives, past history of PID, and past obstetric history were also analysed in this study and found to be associated with chlamydial infection as depicted in the [Table 1]. All the sera were non reactive for RPR test.
Table 1: Association between chlamydia seropositivity and other relevant factors


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In conclusion, it can be presumed that there is a significant role of  Chlamydia trachomatis Scientific Name Search  in infertility and also there is an association between serum anti-chlamydia antibodies and tubal factor infertility, in this part of the country. If chlamydia antibody test is applied as a screening tool early in evaluation, a positive chlamydia antibody test might alert one to the possibility of tubal factors relating to previous chlamydial infection that would not be suspected, otherwise, [4] and it will help to determine whether hysterosalpingography (HSG) or laparoscopy will provide better information needed for planning the treatment. [1],[4] So there is a scope for further study of this causative aspect of infertility with larger number of case studies, in a longer duration of time with well equipped confirmatory diagnostic procedure.

 
 ~ References Top

1.
Jones RB, Batteinger BE. Chlamydia trachomatis (trachoma, perinatal infections, Lymphogranuloma Veneraum and other genital infections). In: Mandell GI, Benett JE, Dolin R, editors. Mandell, Douglas and Benett's Principles and Practice of Infectious Diseases. 5 th ed., Vol 2. London: Churchill Livingstone Elsevier; 2000. p. 1989-2004.  Back to cited text no. 1
    
2.
Cates W Jr, Rolfs RT Jr, Aral SO. Sexually transmitted diseases, pelvic inflammatory disease, and infertility: An epidemiologic update. Epidemiol Rev 1990;12:199-220.  Back to cited text no. 2
    
3.
Cates W Jr, Wasserheit JN. Genital chlamydial infections: Epidemiology and reproductive sequelae. Am J Obstet Gynecol 1991;164:1771-81.  Back to cited text no. 3
    
4.
Speroff L, Fritz MA. Female infertility. In: Speroff L, Fritz MA, editors. Clinical Gynaecologic Endocrinology and Infertility. 7 th ed. New York: Lippincott Williams & Wilkins Press; 2005. p. 1013-68.  Back to cited text no. 4
    
5.
Tyagi P, Singh VS. Chlamydia and gonococal serology in women with tubal infertility. Indian J Med Sci 1998;52:231-5.  Back to cited text no. 5
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6.
Sharma M, Sethi S, Daftari S, Malhotra S. Evidence of chlamydial infection in infertile women with fallopian tube obstruction. Indian J Pathol Microbiol 2003;46:680-3.  Back to cited text no. 6
    



 
 
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