Previously undetected Chlamydia trachomatis infection, immunity to heat shock proteins and tubal occlusion in women undergoing in-vitro fertilization

The relationship between a previously undetected Chlamydia trachomatis infe ction, tubal infertility, immunity to heat shock proteins and subsequent in -vitro fertilization (IVF) outcome was evaluated. Women with tubal occlusio n, with or without hydrosalpinges, and no history of C. trachomatis infecti on were tested for circulating antibodies to the human 60-kDa heat shock pr otein (Hhsp60), the C, trachomatis 10-kDa heat shock protein (Chsp10) and C , trachomatis surface antigens prior to their initial IVF cycle. Sera were obtained from 50 women whose male partners were infertile, 58 women with tu bal occlusion but no hydrosalpinx and 39 women with tubal occlusions plus h ydrosalpinx, Clinical pregnancies were documented in 68% of the women with male factor infertility, This was higher than the 43.1% rate in women with tubal occlusions (P = 0.04) and the 41% rate in women with hydrosalpinx (P = 0.02). C. trachomatis antibodies were present in one (2%) woman with male factor infertility as opposed to 15 (25.9%) women with tubal occlusion (P = 0.003) and 13 (33%) with hydrosalpinx (P < 0.0001). Antibodies to Chsp10 were more prevalent in women with hydrosalpinx (46.8%) than in women with m ale factor infertility (P < 0.0001, 6%) or tubal occlusion (P = 0.0009, 15. 5%), Hhsp60 antibodies were equally more prevalent in women with tubal occl usion plus (46.8%) or minus hydrosalpinx (41.4%) than in women with male fa ctor infertility (P < 0.0002). Hhsp60 was more prevalent in those women pos itive for Chsp10 (P = 0.02) or C, trachomatis (P = 0.04) antibodies than in women lacking these antibodies. There was no relationship between any of t he antibodies measured in sera and IVF outcome.