ELEVATED SERUM CHLAMYDIA-TRACHOMATIS IGG ANTIBODIES - WHAT DO THEY MEAN FOR IVF PREGNANCY RATES AND LOSS

OBJECTIVE: To evaluate the impact of elevated serum Chlamydia IgG anti bodies (Ab) on in vitro fertilization (IVF) outcome in a large inferti lity population.STUDY DESIGN: One hundred ninety-four women under 40 y ears of age undergoing a total of 316 IVF cycles were evaluated. All c ouples with positive serum Chlamydia IgG Ab were pretreated with doxyc ycline, 100 mg twice daily, for 10 days prior to the fil st IVF cycle. RESULTS: One hundred seven women (55.2%) had elevated serum Chlamydia IgG Ab. One hundred seventy-two IVF cycles (54.4%) were in patients w ith elevated Ab as compared to 144 cycles (45.6%) in controls with neg ative Ab. There were no significant differences in mean age, number of mature oocytes obtained or number of embryos transferred between the two groups. Patients with elevated IgG Ab had nit ongoing pregnancy ra te of 30.2% (52/172) and implantation rate of 13.5% (101/746) as compa red to 34.7% (50/144) and 13.6% (88/649) in the negative Ab group, res pectively (P = NS for both). Two ectopic pregnancies occurred in the e levated Ab group (1.2%, 2/172) vs. none in the negative Ab group. The incidence of early pregnancy loss was 8.7% (15/172) and 3.7% (14/144) in the positive and negative Ab groups, respectively (P = NS). CONCLUS ION: The prevalence of elevated serum Chlamydia IgG Ab in patients pre senting for IVF teas higher than in the general population. In the abs ence of an active genital tract infection, the presence of elevated se rum Chlamydia IgG Ab was not associated with a poor IVF outcome when c ouples were treated with antibiotics prior to stimulation. In addition , there was no correlation between IVF outcome and quantitative IgG Ab titers in women with elevated serum Chlamydia Ab. We recommend that a ll couples with elevated titers be treated with doxycycline prior to t he first IVF attempt to optimize pregnancy rates and minimize infectio us complications.