Elevated serum Chlamydia trachomatis IgG antibodies. Association with decreased implantation rates in GIFT

To analyze the impact of elevated Chlamydia IgG antibody (Ab) titers on the outcome of gamete intrafallopian transfer (GIFT) cycles.

We retrospectively evaluated all the GIFT cycles in a five-year period performed at our center. One hundred one women under 40 years of age undergoing a total of 112 consecutive GIFT cycles were included.

Twenty-six cycles (23.2%) were in women with elevated serum Chlamydia IgG Ab, and 86 (76.8%) were in women with negative titers. There were no significant differences in mean age, number of mature oocytes obtained or number of oocytes transferred between the two groups. Patients with elevated IgG Ab had clinical and ongoing pregnancy rates (PR) of 34.6% and 23.1%, respectively, and an implantation rate (IR) of 7.1% (13/184) as compared to a clinical and ongoing PR of 47.7% and 40.7%, respectively, and an IR of 16.5% (61/369) in the negative Ab group, respectively (P = NS for clinical and ongoing PR, P = .003 for IR). No ectopic pregnancies were noted in either group. The incidence of early pregnancy loss was 33.3% (3/9) and 14.6% (6/41) in the positive and negative Ab groups, respectively (P = .40).

The presence of elevated serum Chlamydia IgG Ab was associated with a significantly lower implantation rate, a trend toward a lower PR and a trend toward a higher early pregnancy loss rate as compared to women with negative Ab titers. This group may represent a subset of assisted reproductive technology patients who are less likely to benefit from GIFT.