Chlamydia Genital Infections, Fallopian Tubal Blockage And Infertility
Infertility is a common condition affecting about 1 in 6 couples. The incidence worldwide is about 10% to 15%. About 80 million couples are affected worldwide. It is of two types: Primary infertility when the woman has never conceived; Secondary infertility where she has conceived at least once that resulted in miscarriages or live birth.
Sexually transmitted infections (STDs)/pelvic infections, particularly those associated with chlamydia infection have undoubtedly contributed significantly to the increase in the proportion of infertility attributed to tubal pathologies and blockage. Chlamydia infection is the most common cause of pelvic infections leading to severe tubal blockage and damage, hydrosalpinx, ectopic pregnancy and infertility. Other causes of tubal blockage in the female population include post-abortal and puerperal sepsis.
The most common test to detect chlamydia infection in women is by taking an endocervical swab for chlamydia DNA. First catch urine test for chlamydia DNA and blood tests to detect chlamydia IgM and IgG antibodies are also available. However, testing for IgG alone does not predict active infection. Positive antibody test can be used to predict the absence or presence of tubal damage in significant number of cases. A recent test called ‘highly sensitive CRP’ further improves tubal damage prediction by up to 90% of cases when combined with serum antibody test for Chlamydia. Contact tracing and treatment of sexual partners to prevent repeated exposures is advisable. Repeated infections will almost guaranty tubal damage in more than 70% of cases.
If treated promptly and effectively with appropriate antibiotics the infection can be eradicated and damage to the fallopian tubes and other pelvic organs can be limited or prevented. The tubal damage can involve the ciliary mucosa and/or kinking from adhesions; in addition clubbing and complete blockage of the fimbrial ends can also occur. Hysterosalpingogram and laparoscopy, does not predict ciliary mucosal damage to the tubes; and falloscopy is reportedly to be more effective to assess endo/mucosal-tubal damage; however, this is not routinely done in most fertility units.
If the fallopian tubes are damaged and with hydrosalpinx; bilateral salpingectomy has been reported to improve fertility and outcome in IVF treated patients. Presently, there is little or no evidence to support tubal surgery as a more cost-effective and successful treatment modality than IVF, except in cases of reversal of tubal sterilisation and salpingectomy for hydrosalpinx.
Related post: Uterine fibroid, infertility, IVF and assisted conception techniques
For more information on this topic and other related issues concerning infertility and pregnancy please visit our websites: www.themedisonhospital.com, wwwaguidetoacne.com, www.pregnancythinking.com.
For appointments and consultations on PCOS and infertility or pregnancy related issues, please call our phone lines, 07033761764, 08169060064. You can also email us using info@themedisonhospital.com, info@fertilityassyst.com.
We offer safe, quality and cost-effective specialist women’s services.
