The relation between immunoglobulin G antibodies to Chlamydia trachomatis and poor ovarian response to gonadotropin stimulation before in vitro fertilization.
OBJECTIVE
To determine whether a relation exists between previous exposure to Chlamydia trachomatis and impaired ovarian response to gonadotropin stimulation.


METHODS
Controlled clinical study.


METHODS
Two university IVF centers.


METHODS
Two hundred forty-two patients receiving IVF treatment and 81 control patients. Ninety-four patients with a poor response to IVF, defined by cycle cancellation in response to a daily stimulation dose of 300 IU of FSH, and 148 patients with a good response were matched for age. Twenty-eight pregnant controls and 53 controls of proven fertility also were included.


METHODS
Serum samples were obtained from patients and controls. Serum levels of immunoglobulin (Ig) G antibodies to C. trachomatis were determined by ELISA.


METHODS
The prevalence of serum IgG antibodies to C. trachomatis in critically defined poor responders was compared with that of age-matched good responders.


RESULTS
A significantly higher proportion of poor responders had serum IgG antibodies to C. trachomatis compared with good responders (44.7% and 30.4%, respectively). Patients undergoing IVF had a significantly higher prevalence of IgG antibodies to C. trachomatis (36%) than did either pregnant or nonpregnant controls (12%).


CONCLUSIONS
A significantly higher prevalence of serum IgG antibodies to C. trachomatis was observed in critically defined poor responders, suggesting a possible detrimental effect of C. trachomatis on subsequent ovarian function.
Department of Obstetrics and Gynaecology, St. Michael's Hospital, University of Bristol, United Kingdom.
S D
SD
Keay
R
R
Barlow
A
A
Eley
G M
GM
Masson
F W
FW
Anthony
J M
JM
Jenkins
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D002692:Chlamydia trachomatis / Q000276:immunology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008596:Menotropins / Q000627:therapeutic use*; D010053:Ovary / Q000187:drug effects* / Q000276:immunology; D011247:Pregnancy; D013268:Stimulation, Chemical; D016896:Treatment Outcome
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D008596:Menotropins