TUBAL INFERTILITY - SEROLOGIC RELATIONSHIP TO PAST CHLAMYDIAL AND GONOCOCCAL-INFECTION

Background and Objectives: Sparse data exist for quantifying the assoc iation between Chlamydia trachomatis infection, salpingitis, and tubal infertility. Goal of This Study: To investigate the impact of Neisser ia gonorrhoeae and C. trachomatis in tubal infertility. Study Design: This was a multicenter case-control study that compared women who have bilateral tubal occlusion with other infertile women and age-matched pregnant control subjects. Reproductive and sexual history were record ed, and immunoglobulin G antibodies to C. trachomatis and N. gonorrhoe ae were measured. Results: Women with past chlamydial or gonococcal in fections or both were significantly more likely to have bilateral tuba l occlusion. The majority of women with bilateral tubal occlusion repo rted no history of pelvic inflammatory disease symptoms. Other inferti le women had a prevalence of C. trachomatis antibodies (60%), which wa s similar to that of patients with bilateral tubal occlusion (71%). Co nclusion: Sexually transmitted infections, especially C. trachomatis, are associated with tubal infertility. Because they usually cause no s ymptoms, public health efforts to prevent tubal infertility should foc us on identifying infections in the lower genital tract before they as cend.