Chlamydia trachomatis infection in primary unexplained infertility

Gorini, G; Milano, F; Olliaro, P; Regazzetti, Anne; Rondanelli, E. G.

doi:10.1007/bf00150445

Cited by 11 publications

(3 citation statements)

References 27 publications

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“…21,[24][25][26][27][28] The higher prevalence rates were reported in Palestine (20.2%), Nigeria (28.0%), Netherlands (29.5%), Italy (31.8%), Iran (32.0%), and Tanzania (36.21%). [29][30][31][32][33][34] Studies from New Delhi, India observed also a higher prevalence of CT among infertile women than in current research (28.1% vs 15.6%). 35 The prevalence rate of CT among subfertile women in Vietnam in our study was within the reported range.…”

Section: Discussioncontrasting

confidence: 61%

Prevalence, risk factors and genotyping of chlamydia trachomatis from endocervical specimens of infertile women at a tertiary care hospital, Vietnam

Nguyen,

Do Ngoc,

Nguyen Le

et al. 2024

Int J STD AIDS

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Background To our knowledge, the prevalence, risk factors and distribution of C. trachomatis genotypes are rarely mentioned in Vietnam. This study aimed to find the prevalence, risk factors and distribution of C. trachomatis genotypes in infertile Vietnamese women. Methods Endocervical swabs were collected from infertile women at the National Hospital of Obstetrics and Gynecology, Vietnam, between January 2020 and December 2021. All samples were analyzed for C. trachomatis presence by Cobas 4800 CT/NG Test. Sequencing methods of ompA gene were used to determine the C. trachomatis genotypes. An approximately 1200 bp ompA fragment was aligned with reference sequences from GenBank to identify the corresponding genotype. Results The prevalence of endocervical C. trachomatis infection was 15.6% of 761 participants. Factors independently associated with CT infection among infertile women, obtained by multivariate analysis, included abnormal vaginal discharge, cervicitis, lower abdominal pain, a history of ectopic pregnancy, having more than one sex partner, and age at first intercourse. Among the samples, genotype E (25.93%) was most frequently found, followed by genotypes D/Da (22.23%), F (13.58%), G/Ga (12.35%), J (12.35%), H (6.17%), K (3.70%), B/Ba (2.47%), and I/Ia (1.23%), respectively. Genotype F was related to types of infertility, and genotype H was associated with a history of miscarriage. Conclusions The present study indicated a high prevalence of C. trachomatis in infertile Vietnamese women. The most common genotypes found in this population were E, D, and F. Our findings suggest that routine screening is necessary for early detection and performance of infection control methods.

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Section: Discussioncontrasting

confidence: 61%

Prevalence, risk factors and genotyping of chlamydia trachomatis from endocervical specimens of infertile women at a tertiary care hospital, Vietnam

Nguyen,

Do Ngoc,

Nguyen Le

et al. 2024

Int J STD AIDS

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“…Of the remaining 375 papers, 117 did not classify a definition of unexplained infertility. As a result, a total of 258 primary research papers with full text available were included …”

Section: Resultsmentioning

confidence: 99%

The definition of unexplained infertility: A systematic review

Raperport,

Desai,

Qureshi

et al. 2023

BJOG

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BackgroundThere is no consensus on tests required to either diagnose unexplained infertility or use for research inclusion criteria. This leads to heterogeneity and bias affecting meta‐analysis and best practice advice.ObjectivesThis systematic review analyses the variability of inclusion criteria applied to couples with unexplained infertility. We propose standardised criteria for use both in future research studies and clinical diagnosis.Search strategyCINAHL and MEDLINE online databases were searched up to November 2022 for all published studies recruiting couples with unexplained infertility, available in full text in the English language.Data collection and analysisData were collected in an Excel spreadsheet. Results were analysed per category and methodology or reference range.Main resultsOf 375 relevant studies, only 258 defined their inclusion criteria. The most commonly applied inclusion criteria were semen analysis, tubal patency and assessment of ovulation in 220 (85%), 232 (90%), 205 (79.5%) respectively. Only 87/220 (39.5%) studies reporting semen analysis used the World Health Organization (WHO) limits. Tubal patency was accepted if bilateral in 145/232 (62.5%) and if unilateral in 24/232 (10.3%). Ovulation was assessed using mid‐luteal serum progesterone in 115/205 (56.1%) and by a history of regular cycles in 87/205 (42.4%). Other criteria, including uterine cavity assessment and hormone profile, were applied in less than 50% of included studies.ConclusionsThis review highlights the heterogeneity among studied populations with unexplained infertility. Development and application of internationally accepted criteria will improve the quality of research and future clinical care.

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“…The requirement for intracellular growth on cultured mammalian cells makes detection of C. trachomatis by culture technically difficult and time consuming. Direct detection of C. trachomatis in endocervical samples with an antichlamydial monoclonal antibody or a chlamydial DNA probe is more rapid than culture but has a lower sensitivity (6,7) and still requires laboratory equipment. Development of DNA amplification assays has further increased the sensitivity of endocervical C. trachomatis detection (1,2).…”

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confidence: 99%

Detection of endocervical anti-Chlamydia trachomatis immunoglobulin A in pregnant women by a rapid, 6-minute enzyme-linked immunosorbent assay: comparison with PCR and chlamydial antigen detection methods

Bongiovanni

Inglis

1997

J Clin Microbiol

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There is a need for a rapid, uncomplicated, and inexpensive test for Chlamydia trachomatis infection in women. We evaluated the ability of a 6-min enzyme-linked immunosorbent assay (ELISA) that requires no laboratory equipment (IgA Rapid SeroTest; Savyon Diagnostics) to detect C. trachomatis immunoglobulin A (IgA) in the endocervices of 167 inner-city pregnant women and compared the results with DNA amplification (Amplicor PCR; Roche Diagnostics) and antigen detection (Chlamydiazyme; Abbott Laboratories) performed on the same women. Anti-C. trachomatis IgA was detected in the cervices of 32 women (19.2%). Samples from 23 women (13.8%) were PCR positive, while chlamydial antigen was present in 20 women (12.0%). There was only 1 sample (4.3%) that was positive by PCR but negative by ELISA; 10 samples were ELISA positive and PCR negative. In contrast, seven samples (30.4%) were PCR positive but Chlamydiazyme negative and four were Chlamydiazyme positive and PCR negative. Compared to PCR, the IgA ELISA had a sensitivity of 95.7%, a specificity of 93.1%, a positive predictive value of 68.8%, and a negative predictive value of 99.3%. The antigen assay had a sensitivity of only 69.6%, a specificity of 97.2%, a positive predictive value of 80.0%, and a negative predictive value of 95.2%. In high-risk groups where laboratory testing is not available, or where the patient might not return to obtain her testing result and be treated, the Rapid IgA SeroTest is a viable alternative for detection of cervical C. trachomatis in pregnant women.

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Chlamydia trachomatis infection in primary unexplained infertility

Cited by 11 publications

References 27 publications

Prevalence, risk factors and genotyping of chlamydia trachomatis from endocervical specimens of infertile women at a tertiary care hospital, Vietnam

Prevalence, risk factors and genotyping of chlamydia trachomatis from endocervical specimens of infertile women at a tertiary care hospital, Vietnam

The definition of unexplained infertility: A systematic review

Detection of endocervical anti-Chlamydia trachomatis immunoglobulin A in pregnant women by a rapid, 6-minute enzyme-linked immunosorbent assay: comparison with PCR and chlamydial antigen detection methods

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