[Chlamydia trachomatis--a risk for reproductive capacity in women]

Chlamydia trachomatis is a bacterium which causes in man among others urogenital infections. So far no data were published pertaining to the herd immunity of the population to this infection in the Czech Republic. The objective of the present investigation was to summarize clinical and laboratory results of examined women and to evaluate the assembled data by statistical methods. Special attention was paid to patients examined on account of infertility.

506 women aged 17-50 years (mean age 28 years) were examined. They were divided into five groups (1-cervicitis, 2-pelvic pain, 3-pregnant, 4-sterile, 5-before UPT). Group 4 (sterile) was further subdivided into three categories (4a IVF on account of tubal sterility, 4b IVF on account of non-tubal sterility and 4c others). With regard to the domicile the women were divided into those residing in Prague and those from other towns and rural areas. In all antigenic examinations of smears from the endocervix were made and serological examinations of specific IgA, IgG antichlamydial antibodies. During collection of the smears the appearance of the cervix; discharge, bleeding and pain on examination were evaluated. For statistical evaluation the chi 2 test was used. In 57% of the women from the whole group positive IgG antibodies were detected suggesting a past or present infection. Differences of antigenic or serological positivity between the five different groups were not statistically significant. In category 4a a significantly higher positivity of IgG (2 alpha < 0.001) of antichlamydial antibodies was found (92% patients) than in categories 4b and 4c. 71% women had complaints during examination. The authors did not find a correlation between antigen- and serum positive women indifferent groups and their domicile.

The results provide evidence of a high herd immunity of the population of the Czech Republic to Chlamyata infection. At the same time they prove that post-inflammatory changes caused by Chlamydia trachomatis are the most frequent cause of occlusion of the oviducts and tubal sterility.