Chlamydial antibodies and tubal infertility.

Prevalence of Chlamydia trachomatis antibodies was studied in infertile women with and without tubal obstruction, and in a control group of pregnant women in a Central-African country with a high infertility rate. In comparison with the control group, tubal infertility patients were significantly more likely to have serum antibodies of 1:64 or greater with an age-adjusted odds ratio of 7.8 (95% confidence interval (CI) 3.2-19.1). Infertile women without tubal obstruction had antibody titres similar to the control group with an odds ratio of 1.1 (95% CI: 0.6-1.9). In the tubal infertility group there was a kind of dose-response relationship between chlamydial antibodies and the severity of tubal damage and pelvic adhesions on laparoscopy, with odds ratios of 3.2 (95% CI: 0.7-14.8), 6.2 (95% CI: 1.9-21.6) and 18.1 (95% CI: 6.0-68.5) in the group with mild, moderate and severe pelvic adhesions respectively. This survey adds more evidence to the hypothesis that C. trachomatis is a major agent responsible for tubal infertility in Central Africa.