The prevalence of serum immunoglobulin g antibody to Chlamydia trachomatis in subfertile women presenting at the university of port harcourt teaching hospital, Nigeria.

OBJECTIVES

This study was undertaken to assess the prevalence of IgG antibody to Chlamydia trachomatis in subfertile patients at the University of Port Harcourt Teaching Hospital and to determine associated factors between this and infertility.

STUDY

DESIGN

This case controlled study was conducted among 100 women presenting for infertility consultation at the University of Port Harcourt Teaching Hospital. One hundred women with normal intrauterine pregnancies attending the antenatal clinic were used as controls. A questionnaire was used to obtain information on their socio-demographic data, sexual and obstetric history administered to them. 2mls of venous blood was collected, labelled and sent to the laboratory. The presence of IgG antibody to Chlamydia trachomatis was determined. Hysterosalpingography was performed on all infertile women to assess tubal patency. Data management was with SPSS 15.0 for Windows(®) statistical software.

RESULTS

The mean age of the subjects was 30 ± 3.1 years, median parity 0.5 and average life time sexual partner 3.7 ± 2.8. All the participants in the study were married. 62% of subjects had tertiary education. The Chlamydia trachomatis IgG antibody prevalence in the subfertile population was 74% and 51% in the control group, P<0.001. Tubal occlusion occurred in 58 (78.4%) of cases positive for chlamydia antibody. Pelvic inflammatory disease and mucopurulent discharge were the most common presentating symptoms among Chlamydia antigen positive infertile women, P<0.001. There was an association between subfertility and the number of life time sexual partners. There was an association between subfertility and non usage of condoms.

CONCLUSION

The prevalence IgG antibody to Chlamydia trachomatis was significantly higher in women with subfertility compared to women with proven fertility. There was a strong association between Chlamydia antibody positivity and tubal occlusion. In a resource-poor country such as Nigeria, enzyme immunosorbent assay for chlamydial IgG antibodies may be substituted for HSG for the detection of tubal occlusion.