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[接受不孕症治疗患者的沙眼衣原体感染患病率]

[Prevalence of Chlamydia trachomatis infection in patients treated for infertility].

作者信息

Sobek A, Hladíková B, Koutná O, Kučerová L, Dostálová Z, Sobek A

机构信息

Fertimed, Olomouc/Polanka nad Odrou, vedoucí doc.

出版信息

Ceska Gynekol. 2012 Oct;77(5):476-9.

Abstract

AIM OF THE STUDY

To determine the prevalence of Chlamydia trachomatis infection in patients treated for infertility.

STUDY TYPE

A retrospective analysis.

SETTING

Fertimed, infertility treatment center, Olomouc.

METHOD

At Fertimed, we used DNA detection of Chlamydia trachomatis by the PCR method of the company GeneProof to examine, between 2009-2011, 785 women undergoing one of the infertility treatment methods and their 113 partners. In the second group, we examined 121 oocyte donors and 30 men before sperm donation. We appraised the frequency of Chlamydia trachomatis detection in the specific groups and the clinical impact of the infection on the female reproductive organs.

RESULTS

In the group of women treated for infertility, we detected 20 (2.5%) women with an active infection. After treatment, 9 of them underwent an examination of Fallopian tube patency using the UTHL (ultrasonographically guided transvaginal hydrolaparoscopy) method. In 7 cases, we indicated a bilateral salpingectomy due to a sactosalpinx and in one case severe pelvic adhesions were found (88.9%), and in one patient, the result was normal. In the control group of 43 PCR-negative women who were examined for Fallopian tube patency, 9.3% rate of tubal pathology was found (p<0.001). In the oocyte donor group, we detected the presence of Chlamydia trachomatis in 12 (9.9%) women, and in the sperm donor group, in 7.6% men. Treatment with 500 mg of Sumamed (azithromycin), given in 3 doses, was successful in all of the positive patients.

CONCLUSION

We found that Chlamydia trachomatis detection was lower in the women treated for infertility than in the female donor group. Women with a confirmed infection had a high prevalence of inflammatory changes in the Fallopian tubes compared with women devoid of a confirmed infection. The treatment with azithromycin is effective.

摘要

研究目的

确定接受不孕症治疗患者的沙眼衣原体感染率。

研究类型

回顾性分析。

研究地点

奥洛穆茨的Fertimed不孕症治疗中心。

方法

在Fertimed,我们于2009年至2011年期间,采用GeneProof公司的PCR方法对沙眼衣原体进行DNA检测,检查了785名接受不孕症治疗方法之一的女性及其113名伴侣。在第二组中,我们在卵子捐赠前检查了121名卵子捐赠者和30名男性。我们评估了特定组中沙眼衣原体检测的频率以及感染对女性生殖器官的临床影响。

结果

在接受不孕症治疗的女性组中,我们检测到20名(2.5%)患有活动性感染的女性。治疗后,其中9名女性使用UTHL(超声引导下经阴道水腹腔镜检查)方法进行了输卵管通畅性检查。7例因输卵管积脓行双侧输卵管切除术,1例发现严重盆腔粘连(88.9%),1例患者结果正常。在43名接受输卵管通畅性检查的PCR阴性女性对照组中,发现输卵管病变率为9.3%(p<0.001)。在卵子捐赠者组中,我们在12名(9.9%)女性中检测到沙眼衣原体,在精子捐赠者组中,在7.6%的男性中检测到。所有阳性患者使用500mg速迈(阿奇霉素)分3剂治疗均成功。

结论

我们发现,接受不孕症治疗的女性中沙眼衣原体检测率低于女性捐赠者组。与未确诊感染的女性相比,确诊感染的女性输卵管炎症变化患病率较高。阿奇霉素治疗有效。

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