The Role of Chlamydia trachomatis IgG Antibody Testing in Predicting Tubal Factor Infertility in Northern Iran

Background: The purpose of this study was to investigate the role of Chlamydia serology as a screening test for tubal infertility and to compare the results with hysterosalpingography (HSG) and laparoscopic findings. Materials and Methods: This was a cross-sectional study undertaken on 110 infertile women treated in the IVF Ward, at Emam Khomeini Hospital, Sari, Iran who underwent laparoscopy and HSG as part of their infertility workup. Prior to laparoscopy, 5 ml of venous blood was drawn for measurement of serum Chlamydia IgG antibody titer (CAT). Patients’ tubal status and pelvic findings were compared with CAT, as measured by microimmunofluorescence. Results: Tuboperitoneal abnormalities were seen in 81.4% of seropositive patients versus 13.2% of women who were seronegative. In women with tubal damage, the numbers of positive CATs (≥1:32) were significantly more than in those who had a normal pelvis (66.6% vs. 6.5%, p<0.001). CAT levels were higher in patients who had bilateral hydrosalpinges, bilateral tubal occlusion and pelvic adhesions (severe damage), than those with tubal distortion and unilateral occlusion (mild damage) (p<0.05). The positive likelihood ratio for C. trachomatis antibody testing was 10.28 as compared with HSG, which had a positive likelihood ratio of 3.03. Conclusion: The results of this study revealed that C. trachomatis serology is an inexpensive and non-invasive test for tubal factor infertility screening.