Importance of Evidence of the Presence of AntichlamiaAntibodies in Sterile Wimen - Comparison of MIF andELISA

Overview

Objective:
The objective of our study was to evaluate possibilities of serum examination of inferti-le women, particularly as a screening test of tubal damage, and comparison of two diagnosticmethods.Design: Retrospective study.Setting: The Department of Gynecology - Obstetrics of the General Teaching Hospital and the 1 stMedical Faculty of the Charles University in Prague.Methods: 528 women were included in the study, which were monitored at the 1 st Department ofGynecology - Obstetrics from September 1993 to June 1997. The total group was divided intoinfertile and fertile women (women before artifical termination of pregnancy and pregnant wo-men app. 4 week before delivery). The group of infertile patients was further divided into sub-groups, according to their diagnosis. For all women examined, two smears from cervix were takenfor antigen detection using a direct immunofluorescence method (DIF - DFA, Chlamyset Orion),and using an immuno-enzymatic method (ELISA - Wellcozyme set, Murex). From a blood sample,a level of IgA and IgG anti-Chlamydia antibodies was ascertained. For 200 sero-positive or anti-gen-positive women, we performed tests of the serums preserved, using specific micro-immunoflu-orescence tests (MIF) (SeroFia, MRL, Labsystem Savyon). We determined prevalence of antigen,IgA and IgG antibodies in individual groups and subgroups of women. We compared both sero-diagnostic methods and determined prevalence of specific antibodies for individual species ofChlamydia in the groups and sub-groups.Results: A high prevalence of active Chlamydia infection (11%) was ascertained in the total groupof women. Occurrence of IgG anti-Chlamydia antibodies was statistically significantly higher inthe group of sterile patients, i.e. 63.5, compared to 49.5% in the group of fertile women. In thesubgroup of infertile women with tubal infertility factor, IgG anti-Chlamydia antibodies werediagnosed in 92%, compared to 40% in case of groups with other causes of infertility. MIF methodhas a lower sensitivity then ELISA. For women with tubal infertility factor, 90% of MIF IgGpositive serums are positive for Chlamydia trachomatis.Conclusion: Chlamydia trachomatis is the most frequent agent of tubal damage. Species-specificIgG antibodies would be a useful supplementary initial examination of infertile patients. In caseof positive results, a suspicion of tubal damage is high.

Key words:
tubal infertility factor, Chlamydia trachomatis, anti-Chlamydia antibodies specif ic for