Association between serum chlamydial antibody levels and tubal infertility in tertiary health facility in South-East Nigeria: a case-control study

OBJECTIVES: This study evaluates the association between genital Chlamydial infection and tubal factor infertility in a tertiary health facility in South-East Nigeria. DESIGN: This was a case-control analytical study. SETTING: Gynaecology Clinic and Maternity Unit of the Department of Obstetrics and Gynaecology of the Federal Medical Centre (FMC), Owerri, Imo State, Nigeria. PARTICIPANTS: Ninety-six (96) women with confirmed tubal factor infertility served as the cases, and 96 women with normal intra-uterine pregnancy matched in age served as the control. DATA COLLECTION/INTERVENTION: A structured questionnaire was used to extract information on the sociodemographic data and the sexual history of the participants. About 2mls of blood was collected, the blood was allowed to clot, and the sera were used for the test. STATISTICAL ANALYSIS/MAIN OUTCOME MEASURE: Pearson Chi-square, Fisher's exact test, likelihood ratio and multivariate logistic regression were used to determine risk associations and identify factors independently related to tubal factor infertility. P-value < 0.05 was considered significant. RESULTS: The sociodemographic characteristics of both cases and control did not differ (P = 0.975). The Chlamydial antibody seropositivity was significantly higher in the cases than the control 78(81.2%) versus 13(13.5%) respectively {(P < 0.001; OR (95% CI) = 27.7(12.7–60.2)}. Only lower abdominal pain {(P = 0.011); OR (95% CI) = 4.3(1.4–13.3)}; was independently associated with tubal factor infertility. CONCLUSION: Tubal factor infertility is strongly associated with chlamydial IgG antibodies, and a history of lower abdominal pain significantly predicted tubal factor infertility. FUNDING: The authors paid the cost of procuring the anti-chlamydial ELIZA test kits, plain sample bottles, syringes, gloves and other consumables and stationaries