The Correlation between Chlamydia Trachomatis and Female Infertility: A Systematic Review

Abstract

The impact of Chlamydia trachomatis (CT) infection on female's fertility is not completely established yet, since the level of evidence associating these factors is still weak. Hence, the goal of the present review is to contribute to a better elucidation of this matter. The electronic database chosen was the Medline/PubMed, with the last survey on May 11, 2021. Publication date was used as a filter, with the previous 5 years having been selected. The following describers were used: chlamydia trachomatis AND infertility; chlamydia trachomatis AND tubal alteration AND infertility; chlamydia AND low pregnancy rates. From the 322 studies screened, 293 that failed to meet our eligibility criteria were excluded. Subsequently, we removed seven studies for not having the possible correlation between CT infections and female infertility as its main focus, and three for being about sexually transmitted infections (STIs) in general. Moreover, two studies designed as reviews were also excluded. Ergo, we included 17 studies in our qualitative analysis. The authors conducted research individually and analyzed carefully the studies selected. As we retrieved the information needed for our study through reading the texts, no contact was made with the authors of the studies selected. This systematic review corroborates the hypothesis that CT infection potentiates female infertility, as 76.47% of the included studies found a positive correlation between them. We conclude that there is an important association between CT infection and female infertility. Ergo, making CT screening part of the infertility investigation routine is relevant and has a reasonable justification.

Genome-wide analyses identify 21 infertility loci and over 400 reproductive hormone loci across the allele frequency spectrum

“…Infertility, defined as the inability to achieve pregnancy within 12 months of regular unprotected sexual intercourse, affects one in six couples across the globe 1 . A range of demographic, environmental, and genetic factors may drive infertility, including the age-related decline of sperm and oocyte quality and quantity 2,3 , infectious diseases [4][5][6] , and rare Mendelian disorders such as cystic fibrosis 7,8 . However, the exact cause remains undetermined in up to 28% of couples and 40% of women with infertility 9,10 .…”

The role of infected epithelial cells in Chlamydia-associated fibrosis

“…In similar fashion, chronic genital infection by C. trachomatis serovars D-K can promote scarring-associated infertility. Infection of the upper female genital tract is consistently associated with chronic inflammation as well as fibrosis-related blockage of the fallopian tubes ( Chow et al., 1990 ; Passos et al., 2022 ). Long-term infection by the lymphogranuloma venereum serovars L1-L3 produces similar fibrotic obstruction of the lymphatic system – in severe cases resulting in rectal strictures, fistulae, or elephantiasis of the genitalia ( Mabey and Peeling, 2002 ; Ceovic and Gulin, 2015 ).…”

Prevalence of Chlamydia trachomatis, Ureaplasma parvum and Mycoplasma genitalium in Infertile Couples and the Effect on Semen Parameters

“…U. parvum and M. genitalium are known as urogenital Mycoplasma spp. ( 7 ). These microorganisms are potentially pathogenic species frequently isolated from the human genitourinary tract.…”