A study of chlamydia antibody status in infertile women and its correlation with tubal factor infertility

Background: Persistent exposure to the chlamydia infection results in chronic inflammatory response and increases the risk of tubal damage. Although a few studies have been conducted correlating previous chlamydial infection with laparoscopic findings for TFI no such study has been done from the Indian subcontinent, Methodology: 150 women attending the Gynecology outpatient department of Lady Harding Medical College for female factor infertility were enrolled in the study. Estimation of chlamydial antibodies in blood was done for IgG, IgA, and IgM by commercial ELISA kit. Indirect ELISA technique was performed in house to detect IgG antibody against cHSP60. Laparoscopy was done in all these patients to determine the incidence of TFI and to relate it to seroprevalence of Chlamydia. Further the different chlamydial antibodies were related to the TFI Observations and results Out of 150 patients total of 62 patients were found chlamydia antibody positive. The type of Chlamydia antibody found in 62 Chlamydia positive patients, was IgM antibody in 28(45.1%), IgG antibody in 20(32.2%) and IgA antibody in 14(22.5%) patients. On studying the laparoscopic findings in 62 Chlamydia positive patients it was observed that there were 43(69.3%) with TFI as against 19(30.7%) patients who did not have TFI. When Chlamydia antibody negative patients were correlated with TFI it was found that out of 88 patients 44 had TFI and 44 had NTFI. When the prevalence of type of Chlamydia antibody was studied in TFI and NTFI it was observed that there was no significant difference in the IgM antibodies, which is a marker of recent infection, between TFI and NTFI being 16(57.1%) and 12(42.8%) respectively. On the other hand IgG and IgA antibodies which are observed to be marker of past and persistent infection were significantly higher in patients of TFI as compared to NTFI. IgG antibody against cHSP60 was found to be positive in 29 out of 62 Chlamydia positive patients. Only 1 of the patients who was positive for IgM antibody was also found to be positive for cHSP60 antibody. On the other hand, out of 25 IgG positive patients 19(79.2%) tested positive for cHSP60 antibody while 100% patients of IgA antibody were positive for cHSP60 antibody as well Conclusion In the present study the best antibody which could predict tubal damage accurately was observed to be IgA. Other antibodies IgG and cHSP60 also had strong association with TFI therefore they can also be considered good markers for predicting tubal damage in an infertile patient. These patients should have early diagnostic laparoscopy without delay for optimum management.