Impact ofChlamydia trachomatisin the reproductive setting: British Fertility Society Guidelines for practice

Abstract

Chlamydia trachomatis infection of the genital tract is the most common sexually transmitted infection and has a world-wide distribution. The consequences of infection have an adverse effect on the reproductive health of women and are a common cause of infertility. Recent evidence also suggests an adverse effect on male reproduction. There is a need to standardise the approach in managing the impact of C. trachomatis infection on reproductive health. We have surveyed current UK practice towards screening and management of Chlamydia infections in the fertility setting. We found that at least 90% of clinicians surveyed offered screening. The literature on this topic was examined and revealed a paucity of solid evidence for estimating the risks of long-term reproductive sequelae following lower genital tract infection with C. trachomatis. The mechanism for the damage that occurs after Chlamydial infections is uncertain. However, instrumentation of the uterus in women with C. trachomatis infection is associated with a high risk of pelvic inflammatory disease, which can be prevented by appropriate antibiotic treatment and may prevent infected women from being at increased risk of the adverse sequelae, such as ectopic pregnancy and tubal factor infertility. Recommendations for practice have been proposed and the need for further studies is identified.

Monitoring of Chlamydia Trachomatis Genitourinary Infection in Women - Analytical Comparative Study Using Public Health Records from Two Balkan Countries

“…On the other hand, chlamydial infection was found in 5.7% of women with infertility in Scotland (25) and in 18.6% of infertile women in India where researchers used a highly sensitive diagnostic test (3). Even among couples treated for infertility the frequency of detection of Chlamydia infection varied from 1% to 13% (29). All these figures roughly correspond to the previously observed variability in incidence of this infection for all our patients, in both geographic areas.…”

“…In our study, we performed a secondary analysis dealing with infertility data since Chlamydia trachomatis infection was important causative factor of that condition (29). However, the discrepancy has been noticed between available epidemiological data regarding two data sets: the first, the reported gynaecological diagnosis and, the second, distribution of swabs taken and tested for the presence of chlamydial infection.…”

Human and Pathogen Factors Associated with Chlamydia trachomatis-Related Infertility in Women

“…In the absence of such comprehensive knowledge and subsequent preventive interventions (enhanced diagnosis or vaccine), there is a real opportunity to alleviate some of the risks and costs associated with the pathological outcome of infection by improving guidelines for screening, as recently proposed in the United Kingdom (152). In addition to this, we propose that the improved use of a serological diagnosis of pathology risk, expediting infertility diagnosis for women and also as a tool to predict the risk of ectopic pregnancy or PID in women (20,150) who have had chlamydial infections, should also be rigorously evaluated and considered for routine implementation in both fertility and general practice clinic settings.…”

Infertility-Related Risk Factors: A Systematic Review

“…The studies show that pre-pregnancy diagnosis of Chlamydia trachomatis reduces the abortion caused by PID in 4 weeks. Valid evidence also shows that women with PID are at risk of ectopic pregnancy, fallopian tube infertility and chronic pelvic pain (11). Among the 14 551 reasons or required treatment for IVF mentioned in 2010, most of them are related to fallopian tube.…”