Relation between antibodies toChlamydia trachomatis and spontaneous abortion following in vitro fertilization (original) (raw)
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Unsuspected Chlamydia trachomatis infection and in vitro fertilization outcome
American Journal of Obstetrics and Gynecology, 1994
OBJECTIVE: Chlamydia trachomatis infections of the female genital tract, although a major cause of infertility, are often asymptomatic and undetected. Since many infertile women now seek in vitro fertilization, a procedure whereby fertilization and embryo implantation are precisely timed, we sought to determine the relation between an unsuspected C. trachomatis infection and the ability of embryos to implant and develop after their transfer to the uterus. STUDY DESIGN: At the time of oocyte aspiration, endocervical samples were obtained from 216 women and assayed by enzyme-linked immunoassay for immunoglobulin A antibodies to C. trachomatis structural membrane components and to recombinant C. trachomatis heat shock protein. The presence of C. trachomatis in the cervices was assessed by the polymerase chain reaction. The outcome of each in vitro fertilization cycle was then ascertained. RESULTS: Docytes from 198 (91.7%) of the women were fertilized in vitro and subsequently transferred to the uterus. Term deliveries of healthy infants occurred after 68 (34.3%) of these transfers. Cervical immunoglobulin A antibodies to chlamydial heat shock protein were detected in 5 (7.3%) of the women with term births, and 1 (1.5%) also had immunoglobulin A antibody to chlamydial structural components; 3 (4.4%) were positive by the polymerase chain reaction for C. trachomatis. In contrast, among the 130 women whose embryo transfers did not result in an ongoing pregnancy, 36 (27.7%) had cervical antiheat shock protein immunoglobulin A Ip = 0.0007) and 24 (18.5%) had antichlamydial structural component immunoglobulin A Ip = 0.0002); 15 (11.5%) of these women had positive results of polymerase chain reaction for C. trachomatis. The majority of women with cervical antibodies to chlamydial structural antigens were also positive for antibody to heat shock protein. However, only 35% of the women with antibodies to heat shock protein were also positive for the other chlamydial antibodies. C. trachomatis was detected by polymerase chain reaction in 29.2% of women with anti-C. trachomatis antibodies and 7.8% of women with anti-heat shock protein antibodies. Women positive for antichlamydial immunoglobulin A were more likely to be undergoing a repeat in vitro fertilization cycle than were women who were antibody negative Ip = 0.007). CONCLUSION: Unsuspected C. trachomatis infection or reactivation of an immune response to the C. trachomatis heat shock protein may induce an inflammatory reaction in the uterus that impairs embryo implantation and/or facilitates immune rejection after uterine transfer of in vitro fertilized embryos. (AM J
The Relationship between Chlamydia trachomatis Genital Infection and Spontaneous Abortion
Journal of Reproduction & Infertility, 2016
Background: Chlamydia trachomatis is the etiology of most of sexually transmitted diseases. Colonization of C. trachomatis in the genital tract during early gestation has been associated with preterm birth, and preterm premature rupture of the membranes. The role of C. trachomatis on spontaneous abortion has not yet been proved completely. The aim of this study was to evaluate the frequency of C. trachomatis infection among pregnant women and its association with spontaneous abortion. Methods: This case-control study was conducted from August 2012 until January 2013. Totally, 218 women were included; 109 women with spontaneous abortion with gestation age between 10–20 weeks (cases), and 109 women with normal pregnancy with gestation age between 20–30 weeks (controls) in Sanandaj, Iran. DNA was extracted from endocervical swabs and a PCR test was conducted for detection of C. trachomatis infection in women using specific primers. Independent T-test and Chi-square were used for compar...
Journal of Clinical Pathology, 1988
The efficiency of an immunoperoxidase serological assay and culture of Chlamydia trachomatis were compared in 127 women seeking first trimester abortion. Serum IgG and IgA antibodies specific for C trachomatis wer.e detected by a single serovar (L2) inclusion immunoperoxidase assay (IPA). Eighty (63%) women were seropositive for chlamydial IgG and 31 (24%) for IgA antibodies. C trachomatis was isolated from 21 of 127 (17%) women. Twenty of the 80 women (25%) seropositive for specific IgG antibodies and one of 47 (2%) patients without these antibodies were culture positive (p < 0-001). Compared with isolation, chlamydial antibodies at a titre of > 16 showed high sensitivity and negative predictive value (95% and 98%, respectively), but low specificity and efficiency (43% and 52%, respectively). Chlamydial IgA antibodies at a titre of > 8 showed low sensitivity (52%), but a higher specificity, negative predictive value, and efficiency of 81%, 90%, and 76%, respectively. C trachomatis IgG antibodies at a titre of 16 as determined by IPA can be used as an efficient negative exclusion marker for active chlamydial infection in screening women seeking
Sexually Transmitted Diseases, 2016
Background: Chlamydia trachomatis infection is one of the most common sexually transmitted reported bacterial infections worldwide. The well-known sequelae of chlamydial infection include pelvic inflammatory disease and tubal factor infertility, but the evidence linking C. trachomatis infection and adverse pregnancy outcome is inconsistent and has been largely based on case-control studies with limited study populations. We evaluated this link in a population-based longitudinal biobank health registry setting. Methods: The association between C. trachomatis major outer membrane protein (MOMP) peptide-specific IgG antibodies and ectopic pregnancy, miscarriage, and preterm delivery was examined in a prospective casecontrol study nested in the Finnish Maternity Cohort. Ectopic pregnancy and miscarriage cases were identified through the Hospital Discharge Register 1998-2005; cases with preterm deliveries were identified through the Finnish Medical Birth register 1988-2005. Control samples were retrieved from the Finnish Maternity Cohort serum bank. A total of 800 cases of ectopic pregnancy, 800 cases of miscarriage, and 1350 cases of preterm birth were included. Equal number of pregnant women without the outcome diagnosis served as controls. The cases and controls were matched by sampling time, at the serum sampling and postal code district. Results: Antichlamydial IgG antibodies were associated with ectopic pregnancy. Positive antibody levels were found in 21.0% of cases and 14.6% of controls (P = 0.001; odds ratio, 1.56; 95% confidence interval, 1.20-2.03). Previous exposure to C. trachomatis, as indicated by serum antibodies, doubled the risk of ectopic pregnancy within age and was highest among women 35 years or older. Antichlamydial IgG antibody rates between the cases with miscarriage (16.3% in cases vs. 16.8% in controls) or preterm delivery (18.1% vs. 18.1%) and controls did not differ. Conclusions: Our findings confirm the association between previous exposure to C. trachomatis and ectopic pregnancy. We found no association between C. trachomatis seropositivity and miscarriage or preterm birth. C hlamydia trachomatis infection has been linked to reproductive tract pathology, including pelvic inflammatory disease (PID), tubal factor infertility, and adverse pregnancy outcomes such as ectopic pregnancy, miscarriage, and preterm delivery. 1 C. trachomatis infections are often asymptomatic and thus From the
Autoimmune response to Chlamydia trachomatis infection and in vitro fertilization outcome
Fertility and Sterility, 2009
This observational study was conducted in 235 patients undergoing IVF who had a cervical swab positive for Chlamydia trachomatis and who underwent antibiotic treatment until a negative cervical swab before IVF attempt. After oocyte retrieval, follicular fluids of 109 patients out of 228 still showed the presence of IgA antichlamydia antibodies and a significantly lower pregnancy and implantation rate; therefore we conclude that patients should undergo IVF procedure after serum antichlamydia IgA tests negative.
Chlamydia trachomatis in Women with Ful-Term Deliveries and Women with Abortion
American Journal of Infectious Diseases, 2010
Problem statement: There are some documents which support the role of some certain infections such as Chlamydia trachomatis in spontaneous abortion. As there were not data about role this bacterium in abortion in this area of IRAN, this study was conducted to evaluate the prevalence of Chlamydia trachomatis in women with abortion and compare it with healthy women with no previous history of abortion. Approach: This case-control study was carried out in Shariatee hospital of Hormozgan University of medical sciences, during 2004-2005. A number of 220 women with definite diagnosis of previous abortion and 200 matched women with normal full term delivery and negative history of miscarriage as controls were studied as case and control groups. All obtained PAP smears from the case and the control groups were then tested using Immunoflourescent method for detection of Chlamydia trachomatis. Data was analyzed, using SPSS software (chi square and t-test). Results: The prevalence of positive direct immunofluorescent test on PAP smears indicating the presence of Chlamydia trachomatis was 56 (25.45%) in women with abortion comparing to 13 (5.20%) in women in control group, the difference was significant (p = 0.0001). Conclusion: This study showed Chlamydia trachomatis is an important causative agent for abortion in this area of IRAN.
Human Reproduction, 2004
BACKGROUND: The objective of this study was to determine the prevalence of Chlamydia trachomatis among both men and women seeking help at an infertility clinic, and to prospectively follow the effect of previous infection on pregnancy rates and pregnancy outcome after a long follow-up period (mean 37 months). METHODS: A total of 244 infertile couples was tested for C. trachomatis IgG antibodies, and IgG + couples were also tested for C. trachomatis DNA by PCR in a ®rst-void urine sample. Study parameters were serology, PCR results, clinical diagnoses, treatments, pregnancy rates and pregnancy outcome. As controls, age-matched and spontaneously pregnant women were also tested with serology. RESULTS: The prevalence of IgG antibodies was 24.2, 20.1 and 15.6% among infertile women, infertile men and control women respectively. The prevalence of C. trachomatis DNA was 6.8 and 7.1% among tested women and men respectively. The presence of C. trachomatis IgG antibodies in women was related to tubal factor infertility (TFI) (P = 0.002). Decreased pregnancy rates were seen in couples where the man was IgG + (P = 0.005) with no relationship to TFI. Among women who achieved pregnancy, there was no difference in pregnancy outcome between IgG + or negative couples. CONCLUSIONS: C. trachomatis IgG antibodies in the man of the infertile couple was related to decreased pregnancy rates and to the presence of IgG antibodies in the woman. There was a high prevalence of asymptomatic persistent infections among infertile couples.
Chlamydia trachomatis in Women with Ful-Term Deliveries and Women with Abortion
American Journal of Infectious Diseases, 2010
Problem statement: There are some documents which support the role of some certain infections such as Chlamydia trachomatis in spontaneous abortion. As there were not data about role this bacterium in abortion in this area of IRAN, this study was conducted to evaluate the prevalence of Chlamydia trachomatis in women with abortion and compare it with healthy women with no previous history of abortion. Approach: This case-control study was carried out in Shariatee hospital of Hormozgan University of medical sciences, during 2004-2005. A number of 220 women with definite diagnosis of previous abortion and 200 matched women with normal full term delivery and negative history of miscarriage as controls were studied as case and control groups. All obtained PAP smears from the case and the control groups were then tested using Immunoflourescent method for detection of Chlamydia trachomatis. Data was analyzed, using SPSS software (chi square and t-test). Results: The prevalence of positive direct immunofluorescent test on PAP smears indicating the presence of Chlamydia trachomatis was 56 (25.45%) in women with abortion comparing to 13 (5.20%) in women in control group, the difference was significant (p = 0.0001). Conclusion: This study showed Chlamydia trachomatis is an important causative agent for abortion in this area of IRAN.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2000
To determine the prevalence of antibodies to Chlamydia trachomatis in women presenting with ectopic pregnancies to Groote Schuur Hospital. C. trachomatis antibody titres were measured using a modified micro-immunofluorescence test in women presenting with ectopic pregnancy. Control subjects were drawn from women with term pregnancies and an uneventful reproductive history. Seventy-four patients and controls were studied. Demographic variables were controlled for at time of entry into the study. A significant association between the number of lifetime sexual partners and exposure to C. trachomatis was noted (P = 0.001). Patients with ectopic pregnancies had significantly higher antibody titres than control subjects (P = 0.001), and in both groups the prevalence of background antichlamydial antibody was high (ectopic pregnancies 59%, pregnant controls 32%). While the role of C. trachomatis infection in women who develop ectopic pregnancies needs to be explored further, it seems wise t...