Chlamydial antibody, as determined with an enzyme-linked immunosorbent assay, in tubal factor infertility.
Serum chlamydial antibody (CA), as determined with an enzyme-linked immunosorbent assay (ELISA), was evaluated as a predictor for the presence or absence of tubal factor infertility. Two hundred fifty-eight infertile women had CA drawn at the initial visit of an infertility workup. Of them, 46.3% were CA positive (CA+). One hundred forty-five patients underwent laparoscopy (LPY). Tubal factor was diagnosed in 87.2% of CA+ patients and 13.6% of CA negative (CA-) ones (P less than .001), with a rising frequency by CA positivity. CA correctly predicted the presence or absence of tubal factor in 86.9% of patients. The frequency of abnormal hysterosalpingograms (HSG) was higher in CA+ patients. The predictive values for tubal factor with low, mid and high CA+ were 62.5%, 97.5% and 95.8%, respectively, and for no tubal factor with CA- was 72.3%. Combining HSG with CA- increased that value. Agreement between the LPY and HSG findings by the CA result showed a high correlation. A history of pelvic inflammatory disease (PID) or intrauterine device use was more common in CA+ patients, but only 25.3% of patients with tubal factor had a history of PID. The frequency of positive cervical chlamydial cultures was 0.8%. CA determined with ELISA appears to be an accurate screening test for tubal factor infertility and can be used to reliably select the procedure of choice for tubal evaluation.
Minassian
S S
SS
Department of Obstetrics and Gynecology, Medical College of Pennsylvania, Philadelphia.
Wu
C H
CH
Jungkind
D
D
Gocial
B
B
Filer
R B
RB
Glassner
M
M
D000907:Antibodies, Bacterial / Q000097:blood; D002689:Chlamydia / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay / Q000295:instrumentation*; D005184:Fallopian Tube Diseases / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007074:Immunoglobulin G / Q000032:analysis; D007247:Infertility, Female / Q000175:diagnosis* / Q000209:etiology; D007434:Intrauterine Devices / Q000009:adverse effects; D010535:Laparoscopy; D000292:Pelvic Inflammatory Disease / Q000150:complications; D011237:Predictive Value of Tests
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G