Can history, ultrasound, or ELISA chlamydial antibodies, alone or in combination, predict tubal factor infertility in subfertile women?

Logan, Susan; Gazvani, Rafet; McKenzie, Hamish; Templeton, Alexander Allan; Bhattacharya, Siladitya

doi:10.1093/humrep/deg471

Cited by 28 publications

(23 citation statements)

References 24 publications

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“…28 Clinical history is not reliable in making a diagnosis of Chlamydial infection. 29,30 and WHO estimate that 70-75% of women with Chlamydia trachomatis infection are asymptomatic. 6 Since, this organism is highly prevalent and asymptomatic, a screening programme has been established in some industrialized countries to reduce the rate of PID and its reproductive sequelae.…”

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confidence: 99%

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

2017

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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.

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

2017

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“…Les publications colligeant les pathologies pelviennes retrouvées en coelioscopie chez des femmes séronégatives objective la faible sensibilité (67 %) de cet examen, même s'il est couplé à une anamnèse et à une échographie pelvienne [11]. Dans la méta-analyse de Mol et al [12], la sérologie Chlamydiae montre des résultats comparables à ceux de l'HSG dans le diagnostic d'obstruction tubaire ou d'hydrosalpinx.…”

Section: Sérologie Chlamydiaeunclassified

Pour la pratique systématique d’une cœlioscopie dans le bilan d’une infertilité

Yazbeck

Tohic

Koskas

et al. 2010

Gynécologie Obstétrique & Fertilité

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“…[31][32][33][34][35][36][37][38][39][40][41][42][43][44] The exact definition of tubal pathology was not described in nine studies. 14,15,18,22,24,[27][28][29]31 In the other 23 articles, the definition was mentioned according to predefined criteria.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…In 18 studies, both HSG and DLS were used as reference tests. [13][14][15]17,18,20,[23][24][25]27,32,33,[35][36][37][38][39]43 In five studies, a HSG was used to identify tubal pathology. 16,22,30,40,44 Eight studies reported laparoscopy as the reference standard.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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The value of medical history taking as risk indicator for tuboperitoneal pathology: a systematic review

Luttjeboer

Verhoeve

Dessel

et al. 2009

BJOG

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Background Guidelines recommend diagnostic laparoscopy in subfertile women with known co-morbidities in their medical history. Aggregated evidence underpinning these recommendations is, however, currently lacking.Objective The objective of this study was to perform a systematic review and meta-analysis of the available evidence on the association between items reported during medical history taking and tuboperitoneal pathology. Selection criteria All relevant studies that compared medical history with the presence or absence of tubal pathology.Data collection and analysis Studies comparing medical history with the presence or absence of tubal pathology were included. A diagnosis of tubal pathology had to be made by hysterosalpingography, laparoscopy or a combination of both. In the absence of invasive tubal testing, tuboperitoneal pathology was considered to be absent in case of intrauterine pregnancy. Homogeneity between studies was assessed, and the association between medical history and tubal pathology was expressed as a common odds ratio with a 95% CI. No language restriction was applied. Main resultsWe included 32 studies. In cohort studies, strong associations were found for a history of complicated appendicitis (OR 7.2, 95% CI 2.2-22.8), pelvic surgery (OR 3.6, 95% CI 1.4-9.0) and pelvic inflammatory disease (PID) (OR 3.2, 95% CI 1.6-6.6), and in case-control studies, for a history of complicated appendicitis (OR 3.3, 95% CI 1.8-6.3), PID (OR 5.5, 95% CI 2.7-11.0), ectopic pregnancy (OR 16.0,, endometriosis (OR 5.9, 95% CI 3.2-10.8) and sexually transmitted disease (OR 11.9,3).Author's conclusions Subfertile women reporting a history of PID, complicated appendicitis, pelvic surgery, ectopic pregnancy and endometriosis are at increased risk of having tuboperitoneal pathology. In these women, diagnostic laparoscopy should be offered early in the fertility work-up.

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Can history, ultrasound, or ELISA chlamydial antibodies, alone or in combination, predict tubal factor infertility in subfertile women?

Abstract: Medical history, TVU appearances, and ELISA IgG CAT alone, or in combination, failed to predict accurately TFI in subfertile women.

Cited by 28 publications

References 24 publications

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

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

Pour la pratique systématique d’une cœlioscopie dans le bilan d’une infertilité

The value of medical history taking as risk indicator for tuboperitoneal pathology: a systematic review

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