LOGIN TO YOUR ACCOUNT

Username
Password
Remember Me
Or use your Academic/Social account:

CREATE AN ACCOUNT

Or use your Academic/Social account:

Congratulations!

You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.

Important!

Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message

CREATE AN ACCOUNT

Name:
Username:
Password:
Verify Password:
E-mail:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Akande, V.; Turner, C.; Horner, P.; Horne, A.; Pacey, A.; Soc, B.F. (2010)
Publisher: Taylor & Francis
Languages: English
Types: Article
Subjects: screening, NAAT, Chlamydia, serology, guideline, /dk/atira/pure/subjectarea/asjc/2700/2729, Obstetrics and Gynaecology, Reproductive Medicine, infertility, BFS, /dk/atira/pure/subjectarea/asjc/2700/2743
Chlamydia trachomatis infection of the genital tract is the most common sexually transmitted infection and has a world-wide distribution. The consequences of infection have an adverse effect on the reproductive health of women and are a common cause of infertility. Recent evidence also suggests an adverse effect on male reproduction. There is a need to standardise the approach in managing the impact of C. trachomatis infection on reproductive health. We have surveyed current UK practice towards screening and management of Chlamydia infections in the fertility setting. We found that at least 90% of clinicians surveyed offered screening. The literature on this topic was examined and revealed a paucity of solid evidence for estimating the risks of long-term reproductive sequelae following lower genital tract infection with C. trachomatis. The mechanism for the damage that occurs after Chlamydial infections is uncertain. However, instrumentation of the uterus in women with C. trachomatis infection is associated with a high risk of pelvic inflammatory disease, which can be prevented by appropriate antibiotic treatment and may prevent infected women from being at increased risk of the adverse sequelae, such as ectopic pregnancy and tubal factor infertility. Recommendations for practice have been proposed and the need for further studies is identified.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1The authors gratefully acknowledge the expertise of Professor Gary Entrican (Moredun Research Institute,
    • Baczynska A, Funch P, Fedder J, Knudsen HJ, Birkelund S, Christiansen G. Morphology of human Fallopian tubes after infection with Mycoplasma genitalium and Mycoplasma hominis--in vitro organ culture study. Human Reproduction. 2007; 22:968-979. [PubMed: 17158214]
    • Bakken IJ, Skjeldestad FE, Nordbø SA. C. trachomatis infections increase the risk for ectopic pregnancy: a population-based, nested case-control study. Sex Transm Dis. 2007; 34:166-169. [PubMed: 16837829]
    • Bakken IJ. C. trachomatis and ectopic pregnancy: recent epidemiological findings. Curr Opin Infect Dis. 2008; 21:77-82. [PubMed: 18192790]
    • Beatty WL, Morrison RP, Byrne GI. Persistent chlamydiae: from cell culture to a paradigm for chlamydial pathogenesis. Microbiol Rev. 1994; 58:686-99. [PubMed: 7854252]
    • Bébéar C, de Barbeyrac B. Genital C. trachomatis infections. Clin Microbiol Infect. 2009; 15:4-10.
    • Bezold G, Politch JA, Kiviat NB, Kuypers JM, Wolff H, Anderson DJ. Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia. Fertility & Sterility. 2007; 87:1087-1097. [PubMed: 17433312]
    • Bjartling C, Osser S, Persson K. Deoxyribonucleic acid of C. trachomatis in fresh tissue from the Fallopian tubes of patients with ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol. 2007; 134:95-100. [PubMed: 17280761]
    • Blackwell AL, Thomas PD, Wareham K, Emery SJ, Blackwell AL, Thomas PD, Wareham K, Emery SJ. Health gains from screening for infection of the lower genital tract in women attending for termination of pregnancy. Lancet. 1993; 342:206-210. [PubMed: 8100930]
    • Broder S, Sims S, Rothman C. Frequency of postinsemination infections as reported by donor semen recipients. Fertil Steril. 2007; 88:711-713. [PubMed: 17678913]
    • Brunham RC, Rey-Ladino J. Immunology of Chlamydia infection: implications for a C. trachomatis vaccine. Nature Reviews Immunology. 2005; 5:149-161.
    • Caldwell HD, Kromhout J, Schachter J. Purification and partial characterization of the major outer membrane protein of C. trachomatis. Infection & Immunity. 1981; 31:1161-1176. [PubMed: 7228399]
    • Chrysostomou M, Karafyllidi P, Papadimitriou V, Bassiotou V, Mayakos G. Serum antibodies to C. trachomatis in women with ectopic pregnancy, normal pregnancy or salpingitis. Eur J Obstet Gynecol Reprod Biol. 1992; 44:101-105. [PubMed: 1587374]
    • Clad A, Prillwitz J, Hintz KC, Mendel R, Flecken U, Schulte-Monting J, Petersen EE. Discordant prevalence of C. trachomatis in asymptomatic couples screened using urine ligase chain reaction. European Journal of Clinical Microbiology & Infectious Diseases. 2001; 20:324-328.
    • Coppus SF, Opmeer BC, Logan S, van der Veen F, Bhattacharya S, Mol BW. The predictive value of medical history taking and Chlamydia IgG ELISA antibody testing (CAT) in the selection of subfertile women for diagnostic laparoscopy: a clinical prediction model approach. Human Reproduction. 2007; 22:1353-8. [PubMed: 17234674]
    • Department of Health. National Chlamydia Screening Programme (NCSP) in England: Programme Overview, Core Requirements, Data Collection. Department of Health; London: 2004.
    • Dietrich W, Rath M, Stanek G, Apfalter P, Huber JC, Tempfer C. Multiple site sampling does not increase the sensitivity of C. trachomatis detection in infertility patients. Fertility & Sterility. 2008 EPub Ahead of Print.
    • Dixon-Woods M, Stokes T, Young B, Phelps K, Windridge K, Skukla R. Choosing and using services for sexual health: a qualitative study of women's views. Sexually Transmitted Infections. 2001; 77(5):335-9. [PubMed: 11588278]
    • Duncan B, Hart G, Scoular A, Bigrigg A. Qualitative analysis of psychosocial impact of diagnosis of C. trachomatis: implications for screening. BMJ. 2001; 322(7280):195-9. [PubMed: 11159612]
    • Eggert-Kruse W, Rohr G, Demirakca T, Rusu R, Naher H, Petzoldt D, Runnebaum B. Chlamydial serology in 1303 asymptomatic subfertile couples. Human Reproduction. 1997; 12:1464-1475. [PubMed: 9262279]
    • Eley A, Hosseinzadeh S, Hakimi H, Geary I, Pacey AA. Apoptosis of ejaculated human sperm is induced by co-incubation with C. trachomatis lipopolysaccharide. Human Reproduction. 2005a; 20:2601-2607. [PubMed: 15905291]
    • Eley A, Pacey AA, Galdiero M, Galdiero M, Galdiero F. Can C. trachomatis directly damage your sperm? Lancet Infectious Diseases. 2005b; 5:53-57. [PubMed: 15620561]
    • Fenton KA, Korovessis C, Johnson AM, McCadden A, McManus S, Wellings K, Mercer CH, Carder C, Copas AJ, Nanchahal K, et al. Sexual behaviour in Britain: reported sexually transmitted infections and prevalent genital C. trachomatis infection. Lancet. 2001; 358:1851-1854. [PubMed: 11741624]
    • Forsey JP, Caul EO, Paul ID, Hull MG. C. trachomatis, tubal disease and the incidence of symptomatic and asymptomatic infection following hysterosalpingography. Human Reproduction. 1990; 5:444- 7. [PubMed: 2113932]
    • Gallegos G, Ramos B, Santiso R, Goyanes V, Gosalvez J, Fernandez JL. Sperm DNA fragmentation in infertile men with genitourinary infection by C. trachomatis and Mycoplasma. Fertility & Sterility. 2008; 90:328-334. [PubMed: 17953955]
    • Garnett GP. How much infertility does Chlamydia cause? Sexually Transmitted Infections. 2008; 84:157-158. [PubMed: 18508989]
    • Giertz G, Kallings I, Nordenvall M, Fuchs T, Giertz G, Kallings I, Nordenvall M, Fuchs T. A prospective study of C. trachomatis infection following legal abortion. Acta Obstetricia et Gynecologica Scandinavica. 1987; 66:107-109. [PubMed: 3618133]
    • González-Jiménez MA, Villanueva-Díaz CA. Epididymal stereocilia in semen of infertile men: evidence of chronic epididymitis? Andrologia. 2006; 38:26-30. [PubMed: 16420239]
    • Health Protection Agency; The UK Collaborative Group for HIV and STI Surveillance. Testing times. HIV and other Sexually Transmitted Infections in the United Kingdom. 2007
    • Hillis SD, Owens LM, Marchbanks PA, Amsterdam LF, Mac Kenzie WR. Recurrent chlamydial infections increase the risks of hospitalization for ectopic pregnancy and pelvic inflammatory disease. American Journal of Obstetrics & Gynecology. 1997; 176:103-7. [PubMed: 9024098]
    • Hogan RJ, Mathews SA, Mukhopadhyay S, Summersgill JT, Timms P. Chlamydial Persistence: beyond the Biphasic Paradigm. Infection & Immunity. 2004; 72:1843-1855. [PubMed: 15039303]
    • Holmes, KK.; Sparling, PF.; Mardh, P-A.; Lemon, SM.; Stamm, WE.; Piot, P.; Wasserheit, JN. Sexually Transmitted Diseases. 3rd edn. McGraw Hill; New York: 1999.
    • Horner P. Chlamydia (uncomplicated, genital). BMJ Clinical Evidence. 2008; 5:1607.
    • Horner P, Boag F. accessed 20092006 UK National Guideline for the Management of Genital Tract Infection with C. trachomatis. 2006Available at: http://www.bashh.org/guidelines. http:// www.bashh.org/documents/61/61.pdf
    • Hosseinzadeh S, Brewis IA, Pacey AA, Moore HDM, Eley A. Co-incubation of human spermatozoa with C. trachomatis in vitro causes increased tyrosine phosphorylation of sperm proteins. Infection & Immunity. 2000; 68:4872-4876. [PubMed: 10948099]
    • Hosseinzadeh S, Brewis IA, Eley A, Pacey AA. Co-incubation of human spermatozoa with C. trachomatis serovar E causes premature sperm death. Human Reproduction. 2001; 16:293-299. [PubMed: 11157823]
    • Hosseinzadeh S, Pacey AA, Eley A. C. trachomatis - induced death of human spermatozoa is caused primarily by lipopolysaccharide. The Journal of Medical Microbiology. 2003; 52:193-200.
    • Hosseinzadeh S, Eley A, Pacey AA. Semen quality of men with asymptomatic Chlamydial infection. Journal of Andrology. 2004; 25:104-110. [PubMed: 14662792]
    • Hu D, Hook EW III, Goldie SJ. Screening for C. trachomatis in Women 15 to 29 Years of Age: A Cost-Effectiveness Analysis. Ann Intern Med. 2004; 141:501-513. [PubMed: 15466767]
    • HFEA Code of Practice. 8th Edition. Human Fertilisation and Embryology Authority; London: 2009.
    • Idahl A, Boman J, Kumlin U, Olofsson JI. Demonstration of C. trachomatis IgG antibodies in the male partner of the infertile couple is correlated with a reduced likelihood of achieving pregnancy. Human Reproduction. 2004; 19:1121-1126. [PubMed: 15121732]
    • Imudia AN, Detti L, Puscheck EE, Yelian FD, Diamond MP. The prevalence of Ureaplasma urealyticum, Mycoplasma hominis, C. trachomatis and Neisseria gonorrhoeae infections, and the rubella status of patients undergoing an initial infertility evaluation. Journal of Assisted Reproduction & Genetics. 2008; 25:43-46. [PubMed: 18202910]
    • Johnson A, Horner P. A new role for C. trachomatis serology? Sex Transm Infect. 2008; 84:79-80. [PubMed: 18256104]
    • Joki-Korpela P, Sahrakorpi N, Halttunen M, Surcel HM, Paavonen J, Tiitinen A. The role of C. trachomatis infection in male infertility. Fertility & Sterility. 2009:1448-1450. [PubMed: 18706556]
    • Kalman S, Mitchell W, Marathe R, Lammel C, Fan J, Hyman RW, Olinger L, Grimwood J, Davis RW, Stephens RS. Comparative genomes of Chlamydia pneumoniae and C. trachomatis. Nature Genetics. 1999; 21:385-9. [PubMed: 10192388]
    • Land JA, Evers JL, Goossens VJ. How to use Chlamydia antibody testing in subfertility patients. Hum. Reprod. 1998; 13:1094-1098. [PubMed: 9619578]
    • Low N, Egger M, Sterne JA, Harbord RM, Ibrahim F, Lindblom B, Herrmann B. Incidence of severe reproductive tract complications associated with diagnosed genital Chlamydial infection: the Uppsala Women's Cohort Study. Sexually Transmtitted Infections. 2006; 82:212-218.
    • Low N, McCarthy A, Roberts TE, Huengsberg M, Sanford E, Sterne JA, Macleod J, Salisbury C, Pye K, Holloway A, Morcom A, Patel R, Robinson SM, Horner P, Barton PM, Egger M. Partner notification of chlamydia infection in primary care: randomised controlled trial and analysis of resource use. BMJ. 2006; 332:14-9. [PubMed: 16356945]
    • Machado AC, Guimarães EM, Sakurai E, Fioravante FC, Amaral WN, Alves MF. High titers of C. trachomatis antibodies in Brazilian women with tubal occlusion or previous ectopic pregnancy. Infect Dis Obstet Gynecol. 2007:24816. [PubMed: 17541464]
    • Macleod J, Salisbury C, Low N, McCarthy A, Sterne JA, Holloway A, Patel R, Sanford E, Morcom A, Horner P, et al. Coverage and uptake of systematic postal screening for genital C. trachomatis and prevalence of infection in the United Kingdom general population: cross sectional study. BMJ. 2005; 330:940. [PubMed: 15809231]
    • Macmillan S, Templeton A. Screening for C. trachomatis in subfertile women. Hum Reprod. 1999; 14:3009-3012. [PubMed: 10601088]
    • Manavi K. A review on infection with C. trachomatis. Best Pract Res Clin Obstet Gynaecol. 2006; 20:941-951. [PubMed: 16934531]
    • McNulty CAM, Freeman E, Bowen J, Shefras J, Fenton K. Barriers to opportunistic Chlamydia testing in primary care. British Journal of General Practice. 2004:508-514. [PubMed: 15239912]
    • Michel CE, Sonnex C, Carne CA, White JA, Magbanua JP, Nadala EC Jr, Lee HH. C. trachomatis load at matched anatomic sites: implications for screening strategies. J Clin Microbiol. 2007; 45:1395-402. [PubMed: 17376879]
    • Mol BW, Dijkman B, Wertheim P, Lijmer J, van der Veen F, Bossuyt PM. The accuracy of serum Chlamydial antibodies in the diagnosis of tubal pathology: a meta-analysis. Fertility & Sterility. 1997; 67:1031-7. [PubMed: 9176440]
    • Molano M, Meijer CJ, Weiderpass E, Arslan A, Posso H, Franceschi S, Ronderos M, Munoz N, van den Brule AJ. The natural course of C. trachomatis infection in asymptomatic Colombian women: a 5-year follow-up study. Journal of Infectious Diseases. 2005; 191:907-916. [PubMed: 15717266]
    • Newhall WJ, Batteiger B, Jones RB. Analysis of the human serological response to proteins of C. trachomatis. Infect Immun. 1982; 38:1181. [PubMed: 6185424]
    • National Chlamydia Screening Programme team; Health Protection Agency. National Chlamydia Screening Programme. 2009http://www.chlamydiascreening.nhs.uk/ps/index.html
    • National Collaborating Centre for Women's and Children's Health. Fertility - assessment and treatment for people with fertility problems. RCOG Press; London: 2004.
    • National Collaborating Centre for Women's and Children's Health. Antenatal care - routine care for the healthy pregnant woman. RCOG Press; London: 2008.
    • Odland JO, Anestad G, Rasmussen S, Lundgren R, Dalaker K. Ectopic pregnancy and Chlamydial serology. Int J Gynaecol Obstet. 1993; 43:271-275. [PubMed: 7907037]
    • Paavonen J, Eggert-Kruse W. C. trachomatis: impact on human reproduction. Human Reproduction Update. 1999; 5:433-447. [PubMed: 10582782]
    • Pacey AA, Eley A. Chlamydia and male fertility. Human Fertility. 2004; 7:271-276. [PubMed: 15621892]
    • Patton DL, Askienazy-Elbhar M, Henry-Suchet J, Campbell LA, Cappuccio A, Tannous W, Wang SP, Kuo CC. Detection of C. trachomatis in fallopian tube tissue in women with postinfectious tubal infertility. American Journal of Obstetrics & Gynecology. 1994; 171:95-101. [PubMed: 8030740]
    • Persson K. The role of serology, antibiotic susceptibility testing and serovar determination in genital Chlamydial infections. Best Pract Res Clin Obstet Gynaecol. 2002; 16:801-814. [PubMed: 12473283]
    • Quinn TC, Gaydos C, Shepherd M, Bobo L, Hook EW III, Viscidi R, Rompalo A. Epidemiologic and microbiologic correlates of C. trachomatis infection in sexual partnerships. JAMA. 1996; 276:1737-1742. [PubMed: 8940322]
    • Rank RG, Sanders MM, Patton DL. Increased incidence of oviduct pathology in the guinea pig after repeat inoculation with the Chlamydial agent of guinea pig inclusion conjunctivitis. Sex Transm Dis. 1995; 22:48-54. [PubMed: 7709325]
    • Rice PA, Schachter J. Pathogenesis of pelvic inflammatory disease. What are the questions? JAMA. 1991; 266:2587-2593. [PubMed: 1942405]
    • Royal College of Obstetricians and Gynaecologists. The initial investigation and management of the infertile couple. Royal College of Obstetricians and Gynaecologists; London: 1998.
    • Royal College of Obstetricians and Gynaecologists. Management of acute pelvic inflammatory disease. 2008 Green top guideline No 32.
    • Samra Z, Soffer Y, Pansky M. Prevalence of genital Chlamydia and mycoplasma infection in couples attending a male infertility clinic. European Journal of Epidemiology. 1994; 10:69-73. [PubMed: 7957794]
    • Sanchez-Campillo M, Bini L, Comanducci M, Raggiaschi R, Marzocchi B, Pallini V, Ratti G. Identification of immunoreactive proteins of Chlamydia trachomatis by Western blot analysis of a two-dimensional electrophoresis map with patient sera. Electrophoresis. 1999; 20:2269-79. [PubMed: 10493131]
    • Satta A, Stivala A, Garozzo A, Morello A, Perdichizzi A, Vicari E, Salmeri M, Calogero AE. Experimental C. trachomatis infection causes apoptosis in human sperm. Human Reproduction. 2006:134-137. [PubMed: 16126752]
    • Sherman JK, Jordan GW. Cryosurvival of C. trachomatis during cryopreservation of human spermatozoa. Fertility & Sterility. 1985; 43:664-666. [PubMed: 3987932]
    • Scottish Intercollegiate Guidelines Network. A national clinical guideline. Scottish Intercollegiate Guidelines Network; Edinburgh: 2009. Management of genital C. trachomatis infection; p. 41pphttp://www.sign.ac.uk/pdf/sign109.pdf
    • Simms I, Horner P. Has the incidence of pelvic inflammatory disease following Chlamydial infection been overestimated? Int J STD AIDS. 2008; 19:285-286. [PubMed: 18482954]
    • Sowerby E, Parsons J. Prevention of iatrogenic pelvic infection during in vitro fertilization--current practice in the UK. Human Fertility. 2004; 7:135-140. [PubMed: 15223763]
    • Tedder RS, Zuckerman MA, Goldstone AH, Hawkins AE, Fielding A, Briggs EM, et al. Hepatitis B transmission from contaminated cryopreservation tank. Lancet. 1995; 346:137-140. [PubMed: 7603227]
    • Temple-Smith M, Mulvey G, Keogh L. Attitudes to taking a sexual history in general practice in Victoria, Austrailia. Sexually Transmitted Infections. 1999; 75:41-44. [PubMed: 10448341]
    • Tomlinson M, Pacey AA. Practical aspects of sperm banking for cancer patients. Human Fertility. 2003; 6:100-105. [PubMed: 12960440]
    • Tomlinson, MJ. Sperm processing and storage. In: Pacey, AA.; Tomlinson, MJ., editors. Sperm Banking - Theory & Practice. Cambridge University Press; Cambridge: 2009. p. 86-104.
    • Van Valkengoed IG, Morré SA, Van den Brule AJ, Meijer CJ, Bouter LM, Boeke AJ. Overestimation of complication rates in evaluations of C. trachomatis screening programmes - implications for cost-effectiveness analyses. Int J Epidemiol. 2004; 33:416-425. [PubMed: 15082651]
    • Wallace LA, Scoular A, Hart G, Reid M, Wilson P, Goldberg DJ. What is the excess risk of infertility in women after genital Chlamydia infection? A systematic review of the evidence. Sexually Transmtitted Infections. 2008; 84:171-175.
    • 1. What is C.trachomatis and how it is transmitted
    • 2. The diagnosis of C.trachomatis:
    • 3. The complications of untreated C.trachomatis
    • 4. Side effects and importance of complying fully with treatment and what to do if a
    • 5. The importance of their sexual partner(s) being evaluated and treated.
    • 6. Advised to abstain from sexual intercourse until they and their partner(s) have
  • No related research data.
  • Discovered through pilot similarity algorithms. Send us your feedback.

Share - Bookmark

Cite this article