Investigation on Tubal Infertility and Chlamydia Trachomatis in a Congolese Infertile Population

Infertility of tubal origin is the most frequent in sub-Saharan area. It is due to tuboperitoneal lesions
mainly because of infection; especially sexually transmitted infection. Worldwide, Chlamydia
trachomatis is the main pathogen. In our setting, some studies failed to establish the link between
tubal infertility and chlamydia trachomatis. The current study aimed to determine the local data related
to chlamydia trachomatis role in tubal infertility and the usefulness of Chlamydia trachomatis antibody
titer test (CAT) in discrimination of the patients with and without tuboperitoneal lesions. Patients’
average age was 33.9 ± 4.8 years, average coitarche 19.4 ± 4.4 years and average number of
partners: 3.1 ± 1.6. The level of CAT is correlated to the tuboperitoneal severity. CAT was more
specific (93.3%; CI 95%: 81.7 - 98.6) than sensitive (72.7% CI 95%: 49.8 - 89.3) and discriminated
correctly 89% (AUC = 0.89) of the patients with or without tuboperitoneal lesions. In conclusion, as it
is stated worldwide, Chlamydia trachomatis is the most frequent sexually transmitted pathogen
associated with tubal infertility. CAT has to be used as a tool to select patients to be submitted to
invasive investigation, like laparoscopy. In conclusion, the Chlamydia trachomatis is the most frequent
microorganism associated with tubal infertility in the current study. The CAT level rose steadily with
the severity of the tuboperitoneal lesions. With its higher specificity, the CAT has to be used to select
patients for the more invasive investigations, like laparoscopy, also in our setting.