Antibodies to chlamydia trachohomatis heat shock protein 60 [chlamydial HSP 60] and chlamysia trachomatis major outer membrane proten [MOMP] in women with tubal factor infertility

ABSTRACT

Most of the acute infections of Chlamydia trachomatis are asymptomatic and are thus left untreated. In some women repeated or persistent C. trachomatis infection leads to scarring of the fallopian tube tissue and subsequent infertility because of occlusion of the tubes. Screening for C trachomatis specific antibodies is mandatory in. diagnosing asymptomatic tubal factor infertility [TFI], particularly because it has been shown that C trachomatis is rarely isolated from the upper genital tract and clinical diagnosis requires invasive procedures not routinely available in general practice. C. trachomatis has immunodominant proteins such as major outer membrane protein [MOMP] and Chlamydial heat shock protein6o [chlamydial hsp60] that most of the host's immune response is directed at. The aim of the present study was to evaluate the association between, antibodies to C. trachomatis-specific IgG and chlamydial hsp60 in women with TFI. This study was done on 45 women diagnosed as having TFI by means of hysterosalpingogram [HSG] and laparoscopy, and 31 wives of male factor infertility patients with documented patent tubes by hysterosalpingogram, as a control group. Their age ranged from 19 to 35 years. Antibodies to C. trachomatis-specific IgG were more prevalent in younger women [<25 years old] than older women [>25 years old]. 77% versus 47% in TFI group, and 37% versus 27% in control group. Antibodies to C. trachomatis specific IgG were present in 29 [64%] of 45 women with tubal infertility compared with 10 [32%] of 31 control women. The difference was statistically significant [P=0, 0019]. antibodies to chlamydial hsp60 were significantly higher in TFI patients [28 of 45; 62%] than controls [6 of 31; 20%]. The difference was satistica1ly significant [P 0, 0002], Using the Spearman rank order correlation test, the antibodies chlamydial hsp6o had a highly significant correlation to C. trachomatis specific IgG antibodies in TFI patients [rs 0.53, P<0.001] and in controls [rs= 0.54, P<0.001]. In conclusion, Antibodies to chlamydial hsp60 and C. trachomatis-specific IgG are strongly associated with TFI a when used in combination at initial infertility evaluation, they would provide a rapid non-interventive means of diagnosing tubal factor infertility