Bristol Centre of Reproductive Medicine, Southmead Hospital, Bristol BS10 5NB, UK.
Reprod Biomed Online. 2009 Dec;19(6):847-51. doi: 10.1016/j.rbmo.2009.09.029.
Chlamydia trachomatis poses a potential threat to the fertility of women by causing tubal damage. Many women with serological evidence of past Chlamydia infection have normal tubal appearances on laparoscopic assessment. The aim of this study was to assess if serological evidence of past chlamydial infection affects the likelihood of conception in women with normal tubes. Infertile couples in which the female partner was under the age of 40 years, with normal ovulatory function and a male partner with normal sperm function were studied. All women had normal tubes as assessed by laparoscopy. Serum Chlamydia antibody titres were assayed using the immunofluorescence test. Pregnancy rates were related to grouped Chlamydia antibody titres (<64, 64-256 and > or =512). A total of 174 women were studied. The cumulative pregnancy rates (SE) according to these titres were 45.1% (6.2), 42.6% (9.3), 59.1% (11.8) and the risk ratios (95% confidence interval) were 1, 1.59 (0.82-3.07) and 1.04 (0.52-2.08) respectively. The differences were not statistically significant. Therefore, in women with normal-looking tubes, serological evidence of past chlamydial infection does not appear to have an adverse effect on pregnancy rates. These findings suggest that laparoscopic findings and not Chlamydia serological titres are the key to prognosis.
沙眼衣原体可通过引起输卵管损伤对女性生育能力造成潜在威胁。许多血清学证据表明过去感染过衣原体的女性在腹腔镜评估中输卵管外观正常。本研究旨在评估过去的衣原体感染的血清学证据是否会影响输卵管正常的女性受孕的可能性。研究对象为年龄在 40 岁以下、排卵功能正常且男性伴侣精子功能正常的不孕夫妇。所有女性的输卵管均通过腹腔镜检查正常。使用免疫荧光试验检测血清衣原体抗体滴度。妊娠率与分组的衣原体抗体滴度（<64、64-256 和>或=512）相关。共研究了 174 名女性。根据这些滴度，累积妊娠率（SE）分别为 45.1%（6.2）、42.6%（9.3）、59.1%（11.8），风险比（95%置信区间）分别为 1、1.59（0.82-3.07）和 1.04（0.52-2.08）。差异无统计学意义。因此，在输卵管外观正常的女性中，过去衣原体感染的血清学证据似乎不会对妊娠率产生不利影响。这些发现表明，腹腔镜检查结果而非衣原体血清学滴度是预后的关键。
