Eggert-Kruse W, Rohr G, Demirakca T, Rusu R, Näher H, Petzoldt D, Runnebaum B
Department of Gynaecological Endocrinology and Reproductive Medicine, Women's University Hospital, Heidelberg, Germany.
Hum Reprod. 1997 Jul;12(7):1464-75. doi: 10.1093/humrep/12.7.1464.
The clinical significance of antichlamydial antibodies (Chlam Ab) was determined in a total of 1303 subfertile couples consulting for infertility investigation and treatment. Median age of the women was 30 (range 22-44) years and of the men 33 (range 21-53) years. The median duration of infertility was 4 (range 1-21) years. All patients were asymptomatic for genital tract infection. A comprehensive infertility investigation included examination of the endocrine, cervical, and tubal factor, and semen analysis, antisperm antibody (ASA) testing, sperm-mucus interaction testing in vitro using a standardized protocol, and post-coital testing (PCT). Screening for Chlam IgG Ab was performed in serum of both partners, obtained at the same time. Simultaneous microbial cultures in genital secretions of both partners included a broad spectrum of potentially pathogenic bacteria. Elevated titres of Chlam IgG Ab as seromarker for previous infection were found in 20.8% of all women, and in 12.6% of men. Chlam Ab were significantly more frequent in partners of seropositive patients (in 51.8% of women with a Chlam Ab positive partner, compared to 15.8% of the other women). Microbial screening outcome was not significantly related to results of chlamydial serology in both partners. In women, elevated titres of Chlam Ab were significantly associated with a tubal factor, but were not related to reduced quality of the endocervical mucus (CM), including the in-vitro penetrability of the CM (using partners' or donors' spermatozoa). In males, Chlam Ab were not significantly related to the outcome of semen analysis, including screening for ASA (IgG and/or IgA) in semen, and several parameters of sperm functional capacity. After exclusion of couples with tubal disease, subsequent male fertility did not significantly differ in males with or without Chlam Ab. The results suggest that during basic infertility investigation, positive chlamydial serology as an easy screening procedure indicates a higher risk for a tubal infertility factor. However, in asymptomatic patients, Chlam IgG Ab in serum are not associated with a cervical factor or with the male factor, using several determinants for evaluation of semen quality including subsequent fertilizing capacity.
在总共1303对因不孕不育前来咨询检查和治疗的亚生育夫妇中，确定了抗衣原体抗体（Chlam Ab）的临床意义。女性的中位年龄为30岁（范围22 - 44岁），男性为33岁（范围21 - 53岁）。不孕的中位持续时间为4年（范围1 - 21年）。所有患者均无生殖道感染症状。全面的不孕不育检查包括内分泌、宫颈和输卵管因素检查、精液分析、抗精子抗体（ASA）检测、使用标准化方案进行的体外精子 - 黏液相互作用检测以及性交后试验（PCT）。同时对双方血清进行衣原体IgG抗体筛查。对双方生殖道分泌物进行同步微生物培养，包括多种潜在病原菌。在所有女性中，20.8%发现衣原体IgG抗体滴度升高作为既往感染的血清标志物，男性中这一比例为12.6%。血清学阳性患者的配偶中衣原体抗体明显更常见（衣原体抗体阳性配偶的女性中占51.8%，而其他女性中占15.8%）。双方的微生物筛查结果与衣原体血清学结果无显著相关性。在女性中，衣原体抗体滴度升高与输卵管因素显著相关，但与宫颈黏液（CM）质量下降无关，包括CM的体外穿透性（使用配偶或供体的精子）。在男性中，衣原体抗体与精液分析结果无显著相关性，包括精液中ASA（IgG和/或IgA）筛查以及精子功能能力的几个参数。排除输卵管疾病的夫妇后，有或无衣原体抗体的男性随后的生育能力无显著差异。结果表明，在基本的不孕不育检查中，衣原体血清学阳性作为一种简单的筛查程序表明输卵管不孕因素风险较高。然而，在无症状患者中，血清中的衣原体IgG抗体与宫颈因素或男性因素无关，使用了多种评估精液质量包括随后受精能力的指标。
