Can screening Chlamydia trachomatis by serological tests predict tubal damage in infertile patients?

Effectiveness of screening Chlamydia trachomatis (CT) antibody to predict tubal damage was assessed in this prospective study which was performed in a teaching hospital between September 2003 and September 2004. The study group consisted of 152 patients who underwent laparoscopy for infertility and the control group consisted of 80 fertile women who gave birth in the same hospital. CT antibody levels were measured by IFA (Indirect Fluorescence Assay for CT). Adhesions were defined by Gomel's classification system. Rate of seropositivity of CT was 34.6% in the study group and 22.5% in the control group (p>0.05). In the study group, the sensitivity, specifity, positive predictive and negative predictive values of CT positivity for tubal damage were 40%, 69.5%, 50% and 60.2% respectively. In the infertile group, the rate of tubal adhesion in the CT positive group was 50% and in the CT negative group it was 39.7% (p>0.05). However, there was a positive correlation between the severity of tubo-peritoneal adhesions and seropositivity for CT. In this study, we found out that tubo-peritoneal adhesions could not be predicted by the presence of CT inserum. There was a positive correlation between high CT seropositivity and high degree of adhesions.