Spandorfer S D, Neuer A, LaVerda D, Byrne G, Liu H C, Rosenwaks Z, Witkin S S
Department of Obstetrics and Gynecology, Cornell University Medical College, New York, NY 10021, USA.
Hum Reprod. 1999 Jan;14(1):60-4. doi: 10.1093/humrep/14.1.60.
The relationship between a previously undetected Chlamydia trachomatis infection, tubal infertility, immunity to heat shock proteins and subsequent in-vitro fertilization (IVF) outcome was evaluated. Women with tubal occlusion, with or without hydrosalpinges, and no history of C. trachomatis infection were tested for circulating antibodies to the human 60-kDa heat shock protein (Hhsp60), the C. trachomatis 10-kDa heat shock protein (Chsp10) and C. trachomatis surface antigens prior to their initial IVF cycle. Sera were obtained from 50 women whose male partners were infertile, 58 women with tubal occlusion but no hydrosalpinx and 39 women with tubal occlusions plus hydrosalpinx. Clinical pregnancies were documented in 68% of the women with male factor infertility. This was higher than the 43.1% rate in women with tubal occlusions (P = 0.04) and the 41% rate in women with hydrosalpinx (P = 0.02). C. trachomatis antibodies were present in one (2%) women with male factor infertility as opposed to 15 (25.9%) women with tubal occlusion (P = 0.003) and 13 (33%) with hydrosalpinx (P < 0.0001). Antibodies to Chsp10 were more prevalent in women with hydrosalpinx (46.8%) than in women with male factor infertility (P < 0.0001, 6%) or tubal occlusion (P = 0.0009, 15.5%). Hhsp60 antibodies were equally more prevalent in women with tubal occlusion plus (46.8%) or minus hydrosalpinx (41.4%) than in women with male factor infertility (P < 0.0002). Hhsp60 was more prevalent in those women positive for Chsp10 (P = 0.02) or C. trachomatis (P = 0.04) antibodies than in women lacking these antibodies. There was no relationship between any of the antibodies measured in sera and IVF outcome.
评估了先前未检测到的沙眼衣原体感染、输卵管性不孕、对热休克蛋白的免疫反应与后续体外受精（IVF）结局之间的关系。对有输卵管阻塞（有或无输卵管积水）且无沙眼衣原体感染史的女性，在其首次IVF周期前检测其针对人60 kDa热休克蛋白（Hhsp60）、沙眼衣原体10 kDa热休克蛋白（Chsp10）和沙眼衣原体表面抗原的循环抗体。血清取自50名男性伴侣不育的女性、58名有输卵管阻塞但无输卵管积水的女性以及39名有输卵管阻塞并伴有输卵管积水的女性。男性因素不育女性中有68%记录到临床妊娠。这一比例高于输卵管阻塞女性的43.1%（P = 0.04）和输卵管积水女性的41%（P = 0.02）。男性因素不育女性中有1名（2%）存在沙眼衣原体抗体，而输卵管阻塞女性中有15名（25.9%）（P = 0.003），输卵管积水女性中有13名（33%）（P < 0.0001）。Chsp10抗体在输卵管积水女性中（46.8%）比在男性因素不育女性中（P < 0.0001，6%）或输卵管阻塞女性中（P = 0.0009，15.5%）更普遍。Hhsp60抗体在有输卵管阻塞加（46.8%）或不加（41.4%）输卵管积水的女性中同样比在男性因素不育女性中更普遍（P < 0.0002）。Hhsp60在Chsp10抗体（P = 0.02）或沙眼衣原体（P = 0.04）抗体阳性的女性中比在缺乏这些抗体的女性中更普遍。血清中检测的任何抗体与IVF结局之间均无关联。
