Prevalence of chlamydial and gonococcal infections in infertile Egyptian women with tubal factor

ABSTRACT

This work was carried out to study the prevalence of chlamydial and gonococcal infections among 150 Egyptian infertile women having tubal factor as the only or the major contributing factor for infertility. Another 50 normal women were studied as a control group. Seropositive and cervical mucus positive antichlamydial IgG and IgA antibodies were found to be significantly higher in the study group when compared with corresponding ones in controls. The incidence of seropositive cases was higher among secondary infertile patients. The seropositivity was most prevalent in women aged 26 to 30 years in the study group. No significant difference was found between symptomatology of seropositive patients and control women. As regards the signs, it was found that 89% of patients having adnexal mass[es] were seropositive versus zero in controls at p <0.0001. 60.98% of patients having chronic cervicitis were seropositive compared with 5.56% in controls at p <0.0001. 72.41% of patients having purulent cervical discharge had antibodies versus 20% in controls, at p <0.02. Considering laparoscopic findings, it was found that 33.6% of patients with peritubal adhesions and all patients with frozen pelvis were seropositive. Antichlamydial antibodies were next prevalent in patients with hydrosalpinx [27%], cornual blook [26.7%] and then patients with terminal phimosis [18.5%]. Neisseria gonorrhea was isolated only from cervical secretions of patients in 0.67% of cases as gonococci are hard to find in this later stage. This study suggested that subclinical chlamydial salpingitis is an important cause of tubal infertility in Egyptian women. The presence of adnexal mass[es], chronic cervicitis or purulent cervical discharge may improve the ability to detect antichlamydial infections. A serological test for chlamydia trachomatis is recommended to be done as a routine part of infertility investigations