Screening for Chlamydia trachomatis in subfertile women

Chlamydia trachomatis is the most common sexually transmitted disease in th e UK and Europe. The majority of female infections are asymptomatic and rec ognized sequelae include pelvic inflammatory disease, infertility, and ecto pic pregnancy, Women with chlamydial infection who undergo uterine instrume ntation are recognized to beat risk of ascending infection. Most patients a ttending for infertility investigations and treatment will undergo some for m of uterine instrumentation. Published data regarding the prevalence of ch lamydial infection in the subfertile are few and conflicting. In this study , more than 400 consecutive women presenting for infertility investigation and treatment at a single regional fertility centre were screened for Chlam ydia. Half were screened using enzyme immunoassay (EIA) and half by ligase chain reaction (LCR), Prevalence by diagnostic test was 0% with EIA and 1.9 % with LCR, Overall, the low prevalence was at least partly explained by ol der age. Until more evidence comes from studies testing consecutive subfert ile patients both with EIA and a DNA amplification method such as LCR, cent res using EIA should consider using prophylactic antibiotics prior to uteri ne instrumentation.