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Background: Infertility is a major public health problem in developing countries where pelvic inflammatory disease due mainly to Chlamydia trachomatis and Neisseria gonorrhea infection have been implicated. The role of Chlamydia serology in predicting tubal factor infertility (TFI) has been demonstrated by many researchers elsewhere. However, there are limited data in our environment. This prospective cross-sectional study aims to determine the usefulness of Chlamydia Serology as a screening tool for TFI at Federal Medical Centre, Bida, North Central Nigeria.Methods: 125 women with infertility who met the inclusion criteria were enrolled into the study. Relevant information on their socio-demographic characteristics, gynaecological symptoms and risks factors for infertility were obtained. Participants had Hysterosalpingography (HSG) as part of their fertility work-up while 5ml of venous blood was withdrawn to check for Immunoglobulin G antibody to Chlamydia trachomatis using rapid test kits. The HSG findings were correlated with the result of Chlamydia serology. Data was analyzed using the computer software, Statistical Package for Social Science (SPSS) version 20. The level of significance (p value) was set at 0.05.Results: A total of 120 infertile women completed the study, 5 had incomplete investigations and were excluded from the analysis. The prevalence of TFI was 47.5%, while that of positive chlamydia serology was 36.5%. The prevalence of chlamydial seropositivity was 59.6% for patients with TFI but 15.9% for non-TFI. There was a significant association between positive chlamydia serology and TFI p< 0.05. The study revealed moderate sensitivity 59.6%, and negative predictive value 69.7% but high specificity 84.1% and positive predictive value of 77.2%. In this study the odds for diagnosing tubal infertility was 7.8.Conclusions: Chlamydia serology is useful in predicting TFI and should be incorporated in the routine work up for infertility.
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OBJECTIVE: To investigate the relationship of Ureaplasma urealyticum(UU)and Chlamydia trachomatis(CT)infections with reproductive tract microenvironment changes and clinical infertility.METHODS: From July 2018 to May2019,85 cases of tubal infertility were collected as the infertility group from the Outpatient Department of Reproductive Medicine Center,the Seventh Affiliated Hospital of Sun Yat-sen University.The ultrasonography and hysterosalpingography(HSG)showed normal size and shape of uterine cavity,and complete or incomplete obstruction of one or both fallopian tubes;infertility caused by other factors was excluded. The control group consisted of 45 normal women during the same period who had no previous pregnancy history and HSG showed no obvious abnormal fallopian tube. Vaginal and cervical secretions were collected to detect vaginal cleanliness and UU and CT infection.RESULTS: The vaginal cleanliness（Ⅲ-Ⅳ）of infertility group(18.82%)was more than that of control group(4.4%)(P<0.05).CT(18.82%),U(38.82%),CT+UU(15.29%)and total infection rates(72.94%)in infertility group were higher than those in control group(4.44%,8.89%,2.22% and 15.56%). The difference was statistically significant(P<0.01). Multivariate logistic regression analysis showed that tubal infertility was closely related to CT,UU and CT+UU infection(CT:P=0.046,OR=3.291;UU:P=0.025,OR=2.789;CT+UU:P=0.017,OR=7.528).CONCLUSION: CT and UU infections are strongly associated with tubal infertility. It is necessary to screen all women at childbearing age,especially infertile women,in order to clarify the relationship between these pathogens and impaired fertility and adverse pregnancy outcomes.
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Objective To evaluate the curative effect of fallopian tube perfusion with ozone water in treating obstructed fallopian tube in pluripara.Methods A total of 116 patients with distal fallopian tube obstruction were included in this study.The diagnosis was confirmed by clinical and laboratory materials.The patients were randomly divided into the study group and the control group with 58 patients in each group.During hospitalization period all patients received interventional recanalization therapy for obstructed fallopian tube.For the patients of the study group,ozone water perfusion of fallopian tube was employed,while for the patients of the control group,fallopian tube perfusion with conventional anti-inflammatory drug and antiadhesion solution was adopted.All the patients were followed up for 6 months,the pregnancy rate and the fallopian tube re-occlusion rate of both groups were calculated,and 2 weeks after the treatment the patients'discomfort symptoms were evaluated.Results The success rate of fallopian tube recanalization,the pregnancy rate and the re-obstruction rate in the study group were 93.1％ (54/58),79.3％ (46/58) and 5.2％(3/58) respectively,which in the control group were 91.4％ (53/58),60.3％ (35/58) and 172％ (10/58) respectively.Statistical analysis indicated that no significant difference in the success rate of fallopian tube recanalization existed between the two groups (P＞0.05).The pregnancy rate of the study group was higher than that of the control group,while the re-obstruction rate in the study group was lower than that in the control group;the differences between the two groups were statistically significant (P＜0.05).No significant differences in discomfort symptom scores existed between the two groups (P＞0.05).Conclusion Fallopian tube perfusion with ozone water can be adopted for tubal recanalization,this technique can effectively improve the postoperative pregnancy rate and reduce the tubal re-obstruction rate.
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Objetivo: establecer la asociación entre la infertilidad tubarica y la infección cervical por Chlamydia trachomatis (CT) o Ureaplasma urealiticum (UU), en mujeres infértiles. Métodos: investigación comparativa y aplicada, con diseño de tipo no experimental, de casos y controles, contemporáneo transeccional y de campo, que incluyó 60 mujeres, separadas en dos grupos pareados de acuerdo si eran infértiles (casos) o fértiles (controles), a las cuales se les tomó una muestra de hisopado endocervical para el diagnóstico molecular de CT o UU y se les realizó una histerosalpingografía para evaluar la permeabilidad de las trompas uterinas. Resultados: se detectó una prevalencia en mujeres infértiles y fértiles de infección por CT o UU del 18 por ciento y 35 por ciento, respectivamente; siendo mayor entre las mujeres infértiles, diferencia significativa solo para UU (p<0,05). Se detectó una mayor permeabilidad tubárica en las pacientes fértiles que en las infértiles (80 por ciento vs. 40 por ciento), siendo el compromiso tubárico mayor en las pacientes infértiles (p<0,05). Al asociar el diagnóstico de CT o UU con los resultados de la histerosalpingografía se constató que la detección de uno de estos microorganismos aumentaba casi 3 o 5 veces más la probabilidad de presentar obstrucción tubárica, respectivamente, diferencias no significativas (p>0,05). Conclusión: una gran parte de las mujeres infértiles presentan infección por CT o UU, patógenos de transmisión sexual que pudiesen tener responsabilidad en el daño tubárico.
Objective: to establish the association between tubal infertility and cervical infection by Chlamydia tra-chomatis (CT) or Ureaplasma urealyticum (UU) in infertile women. Methods: a comparative, and applied research with a non-experimental, case-control, contemporary-transactional and field design, including 60 women, separated into two groups matched according whether they were infertile (cases) or fertile (controls), in which was took a sample of endocervical swabs for molecular diagnosis of cT or UU and underwent hysterosalpingography to assess the permeability of the fallopian tubes. Results: it was detected in infertile and fertile women a prevalence of CT or UU infection of 18 percent and 35 percent, respectively; being higher detection among infertile women, although this difference was significant only for UU (p <0.05). Also detected more tubal permeability in fertile patients that in infertile (80 percent vs. 40 percent), being higher in engagement tubal in infertility patients (p<0.05). By associating the diagnosis of both CT and UU with hysterosalpingography'sresults found that the diagnosis of one of these microorganisms increased almost 3 to 5 times more likely to have obstruction of the fallopian tubes, respectively; although this higher risk doesn't showed significance (p>0.05). Conclusion: a large proportion of infertile women have CT or UU infection, sexually transmitted pathogens that might have tubal damage liability.
Subject(s)
Humans , Adult , Female , Chlamydia Infections/diagnosis , Ureaplasma Infections/diagnosis , Infertility, Female/microbiology , Case-Control Studies , Chlamydia trachomatis/genetics , DNA, Bacterial , Electrophoresis, Agar Gel , Fallopian Tubes , Fertility , Hysterosalpingography , Polymerase Chain Reaction , Ureaplasma urealyticum/geneticsABSTRACT
The goal of this study is to evaluate the role and the safety of hysterosalpingography (HSG) technique using intensify X-ray unit and automatic contrast injector in diagnosis of tubal infertility on 200 patients at the Military Hospital No 103 from Sept 2002 to Sept 2004. Results: the technique is highly effective in the diagnosis of tubal infertility with accuracy rate of 90.4% compared with laparoscopy. No complications but there were only 3 cases had infection in the uterus due to no antibiotic was used after HSG