Chlamydial serology in fertile and infertile women

Species-specific circulating antibodies to Chlamydia trachomatis were found in 75% of 48 infertile women with damaged fallopian tubes, 47.5% of 40 parous women seeking sterilisation, 46% of 63 women seeking termination of pregnancy, 31% of 75 infertile women with normal fallopian tubes, and 24% of 72 women using barrier contraception. High titres of antibody (greater than or equal to 1/1024) were found in 46%, 15%, 16%, 8%, and 7% of these groups, respectively, and were common in those women with a history of pelvic inflammatory disease or use of an intrauterine device. Thus, although the presence of antibody to C trachomatis was correlated with tubal damage, it was not diagnostic of tubal disease, since a substantial number of pregnant or potentially fertile women also had serological evidence of chlamydial infection. However, the results show that high titres of chlamydial antibodies in infertile women indicate the need for early laparoscopy to assess tubal status.