[Influence of Chlamydiae serology and the presence of a pelvic inflammatory state on the results of in-vitro fertilization].

The authors investigated the influence of Chlamydiae serology and the presence of a pelvic inflammatory state on the outcome of in-vitro fertilization on the basis of an analysis of 116 stimulation cycles. The study included 71 female patients suffering from infectious sterility of tubular origin with distal lesions. Chlamydiae trachomatis serology was considered to be positive at IgG titers in excess of 1/64. When the serum test was positive, there was a significant reduction in the number of clinical pregnancies and the cleavage rate. The percentage of ectopic pregnancies (6 ectopic pregnancies out of 29 clinical pregnancies) was very high, particularly if the serum test was positive and a pelvic inflammatory state persisting after antibiotic treatment contraindicated microsurgery. Surgery was performed only in favorable cases and did not appear to have any negative impact on the outcome. The presence of a non-stabilized pelvic infectious state was correlated with a significant increase in the drop-out rate and the number of post-menopausal gonadotropin required to achieve stimulation. The fact that unexpected spontaneous pregnancies may occur after an unsuccessful attempt must be taken into account when sterilization or salpingectomy are envisaged in an attempt to improve the outcome.