Mycoplasma genitalium, Chlamydia trachomatis, and tubal factor infertility--a prospective study.

OBJECTIVE

To determine the presence of M. genitalium and C. trachomatis in women attending fertility clinics and to follow these women for the effects of previous infections or tubal damage on pregnancy rate and outcome.

DESIGN

Prospective study.

SETTING

Fertility clinics and university.

PATIENT(S): Two hundred twelve couples attending fertility clinics.

INTERVENTION(S): Blood and cervical swab samples from the women. Tubal status was assessed by culdoscopy and/or laparoscopy.

MAIN OUTCOME MEASURE(S): Presence of M. genitalium and C. trachomatis was determined by polymerase chain reaction. Serum samples were tested for antibodies against M. genitalium and C. trachomatis.

RESULT(S): One swap sample was positive to C. trachomatis and none positive to M. genitalium. Thirty of the 194 women had tubal factor infertility (TFI); 23% and 17% of women with TFI had antibodies to C. trachomatis and M. genitalium, respectively, compared with 15% and 4%, respectively, of women with normal tubes; 36% and 14% of women with a self-reported history of pelvic inflammatory disease (PID) were seropositive to C. trachomatis and M. genitalium, respectively, compared with 10% and 6%, respectively, of women without past PID.

CONCLUSION(S): A strong antibody response against M. genitalium or C. trachomatis but no sign of current or chronic infection was found in women with TFI, indicating that previous infections caused by these microorganisms may have resulted in permanent damage and occlusion of the fallopian tubes.