Chlamydia Trachomatis Infection Amonginfertile Women At The University College Hospital, Ibadan

Abstract

Background: Chlamydia trachomatis infection is reported as the commonest cause of tubal and pelvic infection and by proxy, the commonest cause of tubal damage and female infertility. Serotypes D-K are known to cause sexually transmitted genital tract and neonatal infection. Testing for the presence of Chlamydia trachomatis has been revolutionized by the development of monoclonal antibodies. This study sought to determine the prevalence of Chlamydia trachomatis infection among infertile women at the University College Hospital Ibadan and to determine the diagnostic value of Chlamydia antibody testing. Methodology: A cross-sectional study conducted among two hundred and seventy-three women with infertility attending the gynaecology clinic of the University College Hospital Ibadan. Hysterosalpingography (HSG) was performed on all patients as part of their routine evaluation for infertility. Venous blood was obtained to detect Chlamydia Ig G antibodies using the diagnostic bio-probe (DIA.PROBE) enzyme-linked immunoassay (ELIZA) for the quantitative determination of IgG antibodies specific to chlamydia trachomatis.  Results: Positive test results for Chlamydia trachomatis were recorded amongst 136 women, giving a prevalence of 49.8%. 46(33.8%) women with normal tubal appearance and 90(66.2%) with tubal disease tested positive for Chlamydia antibodies. Bilateral tubal blockage was seen in 77(28.2%), while left and right tubal blockages were seen in 35(12.8%) and 21(7.7%) respectively. The accuracy of Chlamydia antibody testing in predicting tubal patency revealed a sensitivity of 67.7% and positive predictive value of 66.1% using HSG as the gold standard. Chlamydia trachomatis infection was found to be associated with age at sexual debut, history of ectopic pregnancy and previous history of abortion (P<0.05).  Conclusion: This study revealed a high prevalence of Chlamydia trachomatis amongst infertile women especially those with tubal disease. Risk factors associated with the infection such as early age of sexual debut, ectopic pregnancy and abortion further support the role of infectious morbidity especially with Chlamydia trachomatis.