TY - JOUR
T1 - Chlamydia trachomatis immunoglobulin G3 seropositivity is a predictor of reproductive outcomes in infertile women with patent fallopian tubes
AU - Steiner, Anne Z.
AU - Diamond, Michael P.
AU - Legro, Richard S.
AU - Schlaff, William D.
AU - Barnhart, Kurt T.
AU - Casson, Peter R.
AU - Christman, Gregory M.
AU - Alvero, Ruben
AU - Hansen, Karl R.
AU - Geisler, William M.
AU - Thomas, Tracey
AU - Santoro, Nanette
AU - Zhang, Heping
AU - Eisenberg, Esther
N1 - Funding Information:
This work was supported by National Institutes of Health (NIH)/Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) grants U10HD077844 (to A.Z.S.), U10 HD39005 (to M.P.D.), U10 HD38992 (to R.S.L.), U10 HD27049 (to K.T.B.), U10 HD38998 (to R.A. and W.D.S), U10 HD055942, HD055944 (to P.R.C.), U10 HD055936 (to G.M.C.), U10HD055925 (to H.Z.); U10 U54-HD29834 (to the University of Virginia Center for Research in Reproduction Ligand Assay and Analysis Core of the Specialized Cooperative Centers Program in Reproduction and Infertility Research); and an NIH grant UL1 TR000127 (to Pennsylvania State University). We thank Richa Kapil and LaDraka Brown from UAB for their assistance with performing the C. trachomatis elementary-body ELISA.
Funding Information:
A.Z.S. has nothing to disclose. M.P.D. has nothing to disclose. R.S.L. reports a grant from Ferring; and personal fees from Ferring, Astra Zeneca, Euroscreen, Clarus Therapeutics, and Takeda. W.D.S. reports research support grants from AbbVie Pharmaceuticals. K.T.B. has nothing to disclose. P.R.C. has nothing to disclose. G.M.C. is on the advisory board of Bayer Pharmaceuticals; received grants from Bayer Pharmaceuticals and Abbvie Pharmaceuticals; received honoraria from Abbvie Pharmaceuticals. R.A. has nothing to disclose. K.R.H. subcontracted with Yale University/ Reproductive Medicine Network/NICHD for salary support and patient care costs; and has received grants from Ferring International Pharmascience Center US and Roche Diagnostics. W.M.G. was contracted by Yale University (a research center of the Reproductive Medicine Network) to perform the chlamydia serology for the study; contract funds were research funds that went to University of Alabama. T.T. reports an Reproductive Medicine Network grant from NICHD. N.S. has nothing to disclose. H.Z. reports an NIH grant. E.E. has nothing to disclose.
Publisher Copyright:
© 2015 American Society for Reproductive Medicine.
PY - 2015
Y1 - 2015
N2 - Objective To determine if Chlamydia trachomatis (C. trachomatis) seropositivity, as detected by the C. trachomatis elementary body (EB)-based enzyme-linked immunosorbent assay [EB ELISA] predicts pregnancy and pregnancy outcome among infertile women with documented tubal patency. Design Cohort study. Setting Outpatient clinics. Patient(s) In all, 1,250 infertile women with documented tubal patency enrolled in 1 of 2 randomized controlled trials: Pregnancy in Polycystic Ovary Syndrome II; and the Assessment of Multiple Intrauterine Gestations From Ovarian Stimulation. Intervention(s) Sera were analyzed for anti-C. trachomatis immunoglobulin G (IgG)1 and IgG3 antibodies, using a research C. trachomatis EB ELISA. The optical density (OD)405 readings of ≥0.35 and ≥0.1 were considered positive for IgG1 and IgG3, respectively. Main Outcome Measure(s) Primary outcomes included pregnancy, live birth, and ectopic pregnancy. Log-linear regression was used to determine the relative risk after adjusting for age, race, treatment medication, smoking status, and current alcohol use. Result(s) A total of 243 (19%) women were seropositive for anti-C. trachomatis IgG3. They tended to be nonwhite and smokers. Anti-C. trachomatis IgG3 seropositive women were significantly less likely to conceive (risk ratio [RR] 0.65, 95% confidence interval [CI] 0.52-0.83) or to have a live birth (RR 0.59, 95% CI 0.43-0.80); these associations were weakened after adjusting for number of hysterosalpingography-documented patent tubes (RR 0.73, 95% CI 0.56-0.97) and (RR 0.73, 95% CI 0.50-1.04), respectively. Anti-C. trachomatis IgG3 seropositive women who conceived had a ×2.7 risk (95% CI 1.40-5.34) of ectopic pregnancy. Conclusion(s) Even in the presence of tubal patency, anti-C. trachomatis IgG3 seropositivity is associated with a lower likelihood of pregnancy. Anti-C. trachomatis IgG3 seropositive women have as high as 3 times the risk of ectopic pregnancy. Clinical Trial Registration Number PPCOSII: NCT00719186 and AMIGOS: NCT01044862.
AB - Objective To determine if Chlamydia trachomatis (C. trachomatis) seropositivity, as detected by the C. trachomatis elementary body (EB)-based enzyme-linked immunosorbent assay [EB ELISA] predicts pregnancy and pregnancy outcome among infertile women with documented tubal patency. Design Cohort study. Setting Outpatient clinics. Patient(s) In all, 1,250 infertile women with documented tubal patency enrolled in 1 of 2 randomized controlled trials: Pregnancy in Polycystic Ovary Syndrome II; and the Assessment of Multiple Intrauterine Gestations From Ovarian Stimulation. Intervention(s) Sera were analyzed for anti-C. trachomatis immunoglobulin G (IgG)1 and IgG3 antibodies, using a research C. trachomatis EB ELISA. The optical density (OD)405 readings of ≥0.35 and ≥0.1 were considered positive for IgG1 and IgG3, respectively. Main Outcome Measure(s) Primary outcomes included pregnancy, live birth, and ectopic pregnancy. Log-linear regression was used to determine the relative risk after adjusting for age, race, treatment medication, smoking status, and current alcohol use. Result(s) A total of 243 (19%) women were seropositive for anti-C. trachomatis IgG3. They tended to be nonwhite and smokers. Anti-C. trachomatis IgG3 seropositive women were significantly less likely to conceive (risk ratio [RR] 0.65, 95% confidence interval [CI] 0.52-0.83) or to have a live birth (RR 0.59, 95% CI 0.43-0.80); these associations were weakened after adjusting for number of hysterosalpingography-documented patent tubes (RR 0.73, 95% CI 0.56-0.97) and (RR 0.73, 95% CI 0.50-1.04), respectively. Anti-C. trachomatis IgG3 seropositive women who conceived had a ×2.7 risk (95% CI 1.40-5.34) of ectopic pregnancy. Conclusion(s) Even in the presence of tubal patency, anti-C. trachomatis IgG3 seropositivity is associated with a lower likelihood of pregnancy. Anti-C. trachomatis IgG3 seropositive women have as high as 3 times the risk of ectopic pregnancy. Clinical Trial Registration Number PPCOSII: NCT00719186 and AMIGOS: NCT01044862.
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U2 - 10.1016/j.fertnstert.2015.08.022
DO - 10.1016/j.fertnstert.2015.08.022
M3 - Article
C2 - 26413816
AN - SCOPUS:84945584709
VL - 104
SP - 1522
EP - 1526
JO - Fertility and Sterility
JF - Fertility and Sterility
SN - 0015-0282
IS - 6
ER -