Interaction of microbiology and pathology in women undergoing investigations for infertility.
BACKGROUND
Cases of endometriosis with no tubal damage are associated with infertility, suggesting an immunological rather than mechanical barrier to reproduction. Laparoscopy and falloposcopy results of clinically asymptomatic women undergoing investigation of infertility were correlated with the outcomes of microbiological screening for Chlamydia trachomatis, Mycoplasma pneumoniae, Mycoplasma hominis, ureaplasma species, Neisseria gonorrhoeae, Neisseria meningitidis and Chlamydia pneumoniae.


METHODS
A total of 44 women presenting to a hospital IVF service for laparoscopic or laparoscopic/falloposcopic investigation of infertility provided endocervical swabs, fallopian tube washings, and peripheral whole blood for analysis.


RESULTS
Of these 44 women, 15.9% (7) showed evidence of C. trachomatis infection as detected by either PCR or EIA serology. Of these 7 women, 5 (71%) had no or mild endometriosis and 2 (29%) had moderate or severe endometriosis. Of the remaining 37 women who showed no evidence of chlamydial infection, 15 (40.5%) had no or mild endometriosis.


CONCLUSIONS
Women with infertility, but without severe endometriosis at laparoscopy, showed a trend towards tubal damage and a higher rate of previous C. trachomatis infection. Although not statistically significant, this trend would suggest that, where moderate to severe tubal damage is found to be the primary cause of infertility, C. trachomatis infection could be a likely cause for such tubal damage.
Debattista
Joseph
J
Sexual Health and AIDS Service, Prince Charles Hospital, Health Service District, Brisbane, Australia. joedebat@powerup.com.au
Gazzard
Caroline M
CM
Wood
Robyn N
RN
Allan
John A
JA
Allan
Janet M
JM
Scarman
Anthony
A
Mortlock
Miranda
M
Timms
Peter
P
Knox
Christine L
CL
D002690:Chlamydia Infections / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D002692:Chlamydia trachomatis / Q000235:genetics* / Q000302:isolation & purification; D016993:Chlamydophila pneumoniae / Q000235:genetics / Q000302:isolation & purification; D017931:DNA Primers; D004269:DNA, Bacterial / Q000032:analysis; D004715:Endometriosis / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D005187:Fallopian Tubes / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D010535:Laparoscopy; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011793:Queensland / Q000453:epidemiology
D017931:DNA Primers; D004269:DNA, Bacterial