[The effect of chlamydial infection on tubal patency]

The study was carried out on 162 infertile women (110 with primary and 52 with secondary infertility), patients of the University Clinic of Gynecologic Endocrinology and Infertility, Sofia. The present study was designed to estimate the effect of chlamydial infection as a cause of tubal pathology in infertile women. Evidence of past chlamydial infection was determined by the presence of antichlamydial IgG antibodies by commercial ELISA test. 101 of the patients examined were positive for antichlamydial IgG antibodies (62.3%). 76 women were examined for tubal patience by means of hysterosalpingography and/or laparoscopy. 38 women had patient tubes and 38 women had tubal occlusion (20 had bilateral and 18 unilateral 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 the women with patient tubes (44.7%). The risk for tubal obstruction in women with positive serology for Chlamydia is 3.22 compared to 0.85 risk in the women with negative serology for chlamydia. The results of the present study indicate that women with evidence of past chlamydial infection are 4 times more likely to have obstructed fallopian tubes compared to women who had no such evidence. It is mandatory to examine the patient for chlamydial serology at the beginning of the diagnostic protocol in order to ensure adequate management prior to more invasive procedures such as hysterosalpingography or laparoscopy.