Microbiologic study of a chronic inflammation associated with tubal factor infertility: Role of Chlamydia trachomatis

ObjectivesThe clinical and public health relevance of widespread case finding by testing for asymptomatic chlamydia infections is under debate. We wanted to explore future directions for chlamydia control and generate insights that might guide for evidence-based strategies. In particular, we wanted to know the extent to which we should pursue testing for asymptomatic infections at both genital and extragenital sites.MethodsWe synthesised findings from published literature and from discussions among national and international chlamydia experts during an invitational workshop. We described changing perceptions in chlamydia control to inform the development of recommendations for future avenues for chlamydia control in the Netherlands.ResultsDespite implementing a range of interventions to control chlamydia, there is no practice-based evidence that population prevalence can be reduced by screening programmes or widespread opportunistic testing. There is limited evidence about the beneficial effect of testing on pelvic inflammatory disease prevention. The risk of tubal factor infertility resulting from chlamydia infection is low and evidence on the preventable fraction remains uncertain. Overdiagnosis and overtreatment with antibiotics for self-limiting and non-viable infections have contributed to antimicrobial resistance in other pathogens and may affect oral, anal and genital microbiota. These changing insights could affect the outcome of previous cost–effectiveness analysis.ConclusionThe balance between benefits and harms of widespread testing to detect asymptomatic chlamydia infections is changing. The opinion of our expert group deviates from the existing paradigm of ‘test and treat’ and suggests that future strategies should reduce, rather than expand, the role of widespread testing for asymptomatic chlamydia infections.

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Antibodies to Chlamydia trachomatis heat shock proteins in women with tubal factor infertility are associated with prior infection by C. trachomatis but not by C. pneumoniae

Human Reproduction ◽

10.1093/humrep/14.8.1969 ◽

1999 ◽

Vol 14 (8) ◽

pp. 1969-1973 ◽

Cited By ~ 17

Author(s):

K. Persson ◽

S. Osser ◽

S. Birkelund ◽

G. Christiansen ◽

H. Brade

Keyword(s):

Heat Shock ◽

Chlamydia Trachomatis ◽

Heat Shock Proteins ◽

Tubal Factor Infertility ◽

Tubal Factor ◽

Shock Proteins ◽

Prior Infection

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Chlamydia trachomatis and chlamydial heat shock protein 60-specific antibody and cell-mediated responses predict tubal factor infertility

Human Reproduction ◽

10.1093/humrep/del014 ◽

2006 ◽

Vol 21 (6) ◽

pp. 1533-1538 ◽

Cited By ~ 47

Author(s):

A. Tiitinen ◽

H.-M. Surcel ◽

M. Halttunen ◽

S. Birkelund ◽

A. Bloigu ◽

...

Keyword(s):

Heat Shock ◽

Chlamydia Trachomatis ◽

Heat Shock Protein ◽

Specific Antibody ◽

Heat Shock Protein 60 ◽

Tubal Factor Infertility ◽

Tubal Factor

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Chlamydia trachomatis infection among Ghanaian women undergoing hysterosalpingography for suspected tubal factor infertility

International Journal of Gynecology & Obstetrics ◽

10.1002/ijgo.12875 ◽

2019 ◽

Vol 146 (2) ◽

pp. 200-205

Author(s):

Titus Beyuo ◽

Samuel A. Oppong ◽

Ali Samba ◽

Vera M. Beyuo

Keyword(s):

Chlamydia Trachomatis ◽

Chlamydia Trachomatis Infection ◽

Tubal Factor Infertility ◽

Tubal Factor ◽

Ghanaian Women

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Screening of Chlamydia trachomatis and Waddlia chondrophila Antibodies in Women with Tubal Factor Infertility

Microorganisms ◽

10.3390/microorganisms8060918 ◽

2020 ◽

Vol 8 (6) ◽

pp. 918 ◽

Cited By ~ 1

Author(s):

Wies T.M. van Dooremalen ◽

Stephan P. Verweij ◽

Janneke E. den Hartog ◽

Carole Kebbi-Beghdadi ◽

Sander Ouburg ◽

...

Keyword(s):

Chlamydia Trachomatis ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Intracellular Pathogen ◽

Serum Samples ◽

Tubal Factor Infertility ◽

Fertility Clinic ◽

Tubal Factor ◽

Adverse Pregnancy

Waddlia chondrophila is an emerging intracellular pathogen belonging to the order of Chlamydiales, and was previously associated with adverse pregnancy outcomes, as well as tubal factor infertility (TFI). In this study, we investigate the link between both W. chondrophila and Chlamydia trachomatis IgG seropositivity and TFI. Antibodies against both bacteria were measured in 890 serum samples of women visiting a fertility clinic. After a hysterosalpingography and/or laparoscopy, they were classified as either TFI-negative (TFI−) or TFI-positive (TFI+). The total seroprevalence was 13.4% for C. trachomatis and 38.8% for W. chondrophila. C. trachomatis antibodies were present significantly more often in the TFI+ group than in the TFI− group, while for W. chondrophila no difference could be observed. In conclusion, our study confirms the association between C. trachomatis seropositivity and TFI, but no association was found between W. chondrophila seropositivity and TFI. The high percentage of W. chondrophila seropositivity in all women attending a fertility clinic does, however, demonstrate the need for further research on this Chlamydia-like bacterium and its possible role in infertility.

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