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2009, Number 1

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Rev Invest Clin 2009; 61 (1)

Anti-C. trachomatis IgG antibodies levels in serum to identify infertility by tubal damage

Hernández-Trejo M, López-Hurtado M, Arteaga-Troncoso G, Guerra-Infante FM
Full text How to cite this article

Language: Spanish
References: 5
Page: 87-89
PDF size: 110.20 Kb.


Key words:

Chlamydia trachomatis, Infertility by Chlamydia, Tubal occlusion, Anti-Chlamydial antibodies, Tubal factor infertility.

ABSTRACT

Objective. To identify the serologic titers of anti-Chlamydia trachomatis IgG (Ab) antibodies that could be used to differentiate tubal damage infertility from other causes of subfertility in a group of Mexican women. Material and methods. This was a prospective, longitudinal and analytical study of 147 women selected in a non- random way. The women were classified into three sub-groups: 1) infertile women with tubal occlusion detected by laparoscopy (n = 58); 2) infertile women with alternative causes of subfertility (n = 50), and 3) fertile women for the control group (n = 39). An assay of indirect immunofluorescence was performed on all infertile women (n = 108). The results obtained were compared with the laparoscopic and hormonal analyses carried out on the 108 infertile women. The statistical analysis included a model in ROC Curve and Logistical Regression. Results. The results showed that the titer 1:256 is able to differentiate fertile women from infertile women. Moreover, in the adjusted analysis, the titer 1:512 was able to identify infertile women with tubal occlusion (OR 2.6, CI 95% 1.24, 5.4), with a sensibility of 40% and a specificity of 90%. Positive and negative predictive values were 85% and 50%, respectively and the positive and negative likelihood ratios were 3.85 and 0.67, respectively. The pattern of the ROC curve confirmed a court value of 1:512, with an area under the curve of 62.2% (CI 95%: 53.4-72%). Conclusion. A titer greater or equal to 1:512 of anti-C. trachomatis IgG antibodies is useful in the identification of tubal factor infertility.


REFERENCES

  1. Stamm WE. Chlamydia trachomatis Infections: progress and problems. J Infect Dis 1999: 179(Suppl. 2): S380-S383.

  2. Machado ACS, Guimaräes EMB, Sakurai E, Fioravante FCR, Amaral WN, Alves MFC. High Titers of Chlamydia trachomatis antibodies in Brazilian women with tubal occlusion or previous ectopic pregnancy. Infec Dis Obstet Gynecol 2007; ID 24816, 6 pages. Doi:10.1155/2007/24816.

  3. den Hartog JE, Land, JA, Stassen FRM, Kessels AGH, Bruggeman CA. Serological markers of persistent C. trachomatis infections in women with tubal factor subfertility. Hum Reprod 2005; 4: 986-90.

  4. Akande VA, Hunt LP, Cahill EO, Caul WC, Ford WCL, Jenkins JM. Tubal damage in infertile women: prediction using Chlamydia serology. Hum Reprod 2003; 18: 1841-7.

  5. Guerra-Infante FM, Carballo-Perea R, Zamora-Ruiz A, López-Hurtado M, Flores-Medina S, Miranda-Contreras G. Evaluation of an indirect immunofluorescence assay (IFA) for detecting Chlamydia trachomatis as a method for diagnosing tubal factor infertility in Mexican women. Inter J Fertil & Women’s Med 2003; 48: 74-82.




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Rev Invest Clin. 2009;61