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  • Title: Chlamydial antibody, as determined with an enzyme-linked immunosorbent assay, in tubal factor infertility.
    Author: Minassian SS, Wu CH, Jungkind D, Gocial B, Filer RB, Glassner M.
    Journal: J Reprod Med; 1990 Feb; 35(2):141-5. PubMed ID: 2137537.
    Abstract:
    Serum chlamydial antibody (CA), as determined with an enzyme-linked immunosorbent assay (ELISA), was evaluated as a predictor for the presence or absence of tubal factor infertility. Two hundred fifty-eight infertile women had CA drawn at the initial visit of an infertility workup. Of them, 46.3% were CA positive (CA+). One hundred forty-five patients underwent laparoscopy (LPY). Tubal factor was diagnosed in 87.2% of CA+ patients and 13.6% of CA negative (CA-) ones (P less than .001), with a rising frequency by CA positivity. CA correctly predicted the presence or absence of tubal factor in 86.9% of patients. The frequency of abnormal hysterosalpingograms (HSG) was higher in CA+ patients. The predictive values for tubal factor with low, mid and high CA+ were 62.5%, 97.5% and 95.8%, respectively, and for no tubal factor with CA- was 72.3%. Combining HSG with CA- increased that value. Agreement between the LPY and HSG findings by the CA result showed a high correlation. A history of pelvic inflammatory disease (PID) or intrauterine device use was more common in CA+ patients, but only 25.3% of patients with tubal factor had a history of PID. The frequency of positive cervical chlamydial cultures was 0.8%. CA determined with ELISA appears to be an accurate screening test for tubal factor infertility and can be used to reliably select the procedure of choice for tubal evaluation.
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