Influence of chlamydia infection history on tubal patency: A pilot study

Chlamydia infection is a known risk factor for tubal occlusion and subsequent infertility. A significant proportion of Chlamydia infections are asymptomatic, which can delay diagnosis and allow silent progression of tubal damage. Therefore, identifying a history of Chlamydia infection-even in the absence of symptoms-may help recognize women at risk of tubal involvement. In such cases, it would be justified to perform tubal patency testing to assess potential tubal and pelvic sequelae. Our purpose was to evaluate the relationship of Chlamydia IgG serology with tubal patency as determined by Hysterosonosalpingo-Foam-Sonography (HyFoSy). Furthermore, the study examines whether this information could guide decision-making in the initial clinical evaluation of infertile patients.

A retrospective pilot study was performed including all patients referred for primary infertility to the Reproductive Medicine Unit of the Gynecology Service of the Hospital Arnau de Vilanova in Lleida between 2022 and 2024. Chlamydia infection history was assessed through serological IgG testing, and tubal patency was evaluated using HyFoSy.

Seventy-nine patients were included in the study. A Chlamydia IgG seropositivity rate of 13.9% was observed, while tubal occlusion-assessed through HyFoSy-was detected in 25.3% of cases. Patients younger than 33 years with a positive Chlamydia IgG testing showed a higher rate of tubal occlusion compared to patients with negative serology (OR 8.00, 95% CI [1.08, 59.16]). No differences were observed in older patients.

Chlamydia infection may be associated with a higher risk of tubal occlusion in younger patients, especially those under 33 years.