title: Molecular investigation of menstrual tissue for the presence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis collected by women with a history of infertility.
abstract: OBJECTIVE
  At present, routine laboratory investigation of the infectious agents implicated in female genital infections is mainly based on culture/direct fluorescence antibody (DFA) (immunofluorescence antibody test) results of cervicovaginal secretions. In this study the use of the menstrual tissue is introduced for the molecular detection of pathogens which are implicated in female infertility.
  
  
  METHODS
  Cervicovaginal secretions and menstrual tissue samples of 87 women (mean age 34.07 ± 5.17) experiencing infertility problems were screened for Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis presence using polymerase chain reaction (PCR, light cycler-PCR). Cervicovaginal secretions were also tested by the culture/DFA technique. The results were compared using the binomial test.
  
  
  RESULTS
  In the overall study group, the prevalence of C. trachomatis was 25.3%, 18.3%, and 13.8%, the prevalence of U. urealyticum was 18.3%, 16.09% and 12.6% and the prevalence of M. hominis was 13.7%, 19.5% and 8.0% in the menstrual tissue, cervicovaginal secretions using PCR and cervicovaginal secretions culture/DFA, respectively. A statistically significant difference was revealed between the two methods for all three microbes and between menstrual tissue and cervicovaginal secretions PCR for chlamydia.
  
  
  CONCLUSIONS
  The use of menstrual tissue along with the PCR method seems to be an effective and thus novel alternative for the investigation of the infectious agents lying in the genital tract. One of the main advantages of this technique compared to cervicovaginal secretions is that it is non-invasive and the sample can be collected at home, thus allowing the early detection and treatment of a condition that can otherwise lead to serious consequences, such as tubal obstruction, pelvic inflammatory disease, ectopic pregnancy, spontaneous abortions and unexplained infertility.
authors.affiliation: Department of Molecular Pathology and Genetics, Locus Medicus Laboratory, Athens, Greece; Embryology and Histology Department, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: I Vassiliki
authors.initials: IV
authors.lastname: Michou
authors.forename: Pantelis
authors.initials: P
authors.lastname: Constantoulakis
authors.forename: Kostantinos
authors.initials: K
authors.lastname: Makarounis
authors.forename: Giorgos
authors.initials: G
authors.lastname: Georgoulias
authors.forename: Vassilis
authors.initials: V
authors.lastname: Kapetanios
authors.forename: Vassilis
authors.initials: V
authors.lastname: Tsilivakos
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000378:metabolism / Q000382:microbiology*; D002690:Chlamydia Infections / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology; D002692:Chlamydia trachomatis / Q000145:classification / Q000302:isolation & purification* / Q000378:metabolism; D004269:DNA, Bacterial / Q000378:metabolism; D004717:Endometrium / Q000378:metabolism / Q000382:microbiology*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000382:microbiology; D008598:Menstruation; D058889:Molecular Typing; D009175:Mycoplasma Infections / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology; D019535:Mycoplasma hominis / Q000145:classification / Q000302:isolation & purification* / Q000378:metabolism; D016133:Polymerase Chain Reaction; D015995:Prevalence; D060737:Reproductive Tract Infections / Q000453:epidemiology / Q000382:microbiology* / Q000503:physiopathology; D016869:Ureaplasma Infections / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology; D016990:Ureaplasma urealyticum / Q000145:classification / Q000302:isolation & purification* / Q000378:metabolism; D014621:Vagina / Q000378:metabolism / Q000382:microbiology*
chemical_list: D004269:DNA, Bacterial
keywords: Chlamydia trachomatis; Mycoplasma hominis; Ureaplasma urealyticum; infertility; menstrual tissue; sexually transmitted infection