[The most suitable tests for studying chlamydial infection in women with sterility]

The study was carried out on 280 infertile women (185 with primary and 95 with secondary infertility), patients of the University Clinic of Gynecologic Endocrinology and Infertility, Sofia. The present study was designed to estimate which is the most suitable test for detection of chlamydial infection in women with infertility. Evidence of past chlamydial infection was determined by the presence of antichlamydial IgG antibodies by commercial ELISA test. From 196 of the patients examined, 101 were positive for antichlamydial IgG antibodies (62.7%). 84 women were examined by means of direct antigen test for Chlamydia trachomatis from the endocervix (DIF. ELISA). Tubal patient was examined by means of hysterosalpingography and/or laparoscopy. In 34 women with unilateral or bilateral tubal occlusion the endocervical direct antigen test was positive in 4 (11.8%) and in 30 women with patient tubes 2 were positive by this test (6.7) In 38 women with tubal occlusion 29 of the women with unilateral or bilateral tubal occlusion had a presence of IgG antichlamydial antibodies in their sera (76.3%) compared to 17 of 38 women with patient tubes (44.7%). The results of the present study indicate that the examination antichlamydial IgG antibodies in the sera of women with infertility has a better predictive value with regard to tubal pathology compared to the direct antigen test for detection Chlamydia trachomatis in the endocervix. Examination for latent infection or reinfection has to be carried out before the administration of more invasive methods for the management of infertility.