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Anti-Chalmydial Antibody As a Predictive Test for Tubal Factor Infertility
Al-Azhar Med. J. Vol. 49(1), January, 2020, 229-240 DOI : 10.12816/amj.2020.67131 https://amj.journals.ekb.eg/article_67131.html ANTI-CHALMYDIAL ANTIBODY AS A PREDICTIVE TEST FOR TUBAL FACTOR INFERTILITY By Emad A. El-Tamamy, Ashraf H. Mohamed, Wael R. Hablas* and Shaban H. Abd El-Rahman ** Departments of Obstetrics & Gynecology and Clinical Pathology*, Faculty of Medicine, Al-Azhar University **Corresponding E-mail: [email protected] ABSTRACT Background: Infertility is a common gynaecological problem that has a multi factorial aetiology. Conception and pregnancy depend on complex physiological, anatomic and immunological factors. Objective: to evaluate the prevalence of chlamydial infection, especially subclinical cases, in a population of Egyptian tubal infertile women and to relate it to history, symptoms, clinical, and laparoscopy findings. Finally, to find any advantage of detecting antichlamydial antibodies in serum of these patients and evaluate its importance in prediction of tubal factor of infertility. Patients and Methods: This study includes 50 primary or secondary infertile females (patients group) their age between 20-30 years, and 50 random fertile females (control group) and Blood sample for IgG, Chlamydia trachomatis antibodies were drawn from all cases of the study for ELISA test. Results: The prevalence rate of Chlamydia trachomatis IgG antibodies was significantly higher in infertile group than that of control group. There was significant higher rate and ratio of positive results in infertile group than that of control group concerning anti-chlamydial IgG. There was a strong correlation between serum levels of anti-chlamydial IgG in the infertility patients. There was a significant correlation between serum anti-chlamydial IgG levels and the duration of infertility. -
Detection of Mycoplasma Genitalium in Women with Laparoscopically
463 MYCOPLASMA GENITALIUM Detection of Mycoplasma genitalium in women with laparoscopically diagnosed acute salpingitis C R Cohen, N R Mugo, S G Astete, R Odondo, L E Manhart, J A Kiehlbauch, W E Stamm, P G Waiyaki, P A Totten ............................................................................................................................... Sex Transm Infect 2005;81:463–466. doi: 10.1136/sti.2005.015701 Objectives: Mycoplasma genitalium has been associated with cervicitis, endometritis, and tubal factor See end of article for infertility. Because the ability of this bacterium to ascend and infect the fallopian tube remains undefined, authors’ affiliations we performed an investigation to determine the prevalence of M genitalium in fallopian tube, endometrial, ....................... and cervical specimens from women laparoscopically diagnosed with acute salpingitis in Nairobi, Kenya. Correspondence to: Methods: Women presenting with pelvic inflammatory disease were laparoscopically diagnosed with Craig R Cohen, MD, MPH, salpingitis. Infection with M genitalium in genital specimens was determined by polymerase chain reaction 74 New Montgomery Street, Suite 600, UCSF, (PCR). Box 0886, San Francisco, Results: Of 123 subjects with acute salpingitis, M genitalium was detected by PCR in the cervix and/or CA 94105, USA; ccohen@ endometrium in nine (7%) participants, and in a single fallopian tube specimen. In addition, those infected psg.ucsf.edu with M genitalium were more often HIV infected than women not infected by M genitalium (seven of nine Accepted for publication (78%) v 42 of 114 (37%), p,0.03). 26 April 2005 Conclusions: M genitalium is able to ascend into the fallopian tube, but its association with tubal pathology ....................... requires further investigation. elvic inflammatory disease (PID) is the most common the female upper genital tract and cause tubal disease has not serious gynaecological disorder diagnosed in women and been firmly established. -
Tubal Damage, Infertility and Tubal Ectopic Pregnancy: Chlamydia Trachomatis and Other Microbial Aetiologies
2 Tubal Damage, Infertility and Tubal Ectopic Pregnancy: Chlamydia trachomatis and Other Microbial Aetiologies Louise M. Hafner and Elise S. Pelzer Institute of Health and Biomedical Innovation, (IHBI), Queensland University of Technology (QUT) Australia 1. Introduction Infertility is a worldwide health problem with one in six couples suffering from this condition and with a major economic burden on the global healthcare industry. Estimates of the current global infertility rate suggest that 15% of couples are infertile (Zegers- Hochschild et al., 2009) defined as: (1) failure to conceive after one year of unprotected sexual intercourse (i.e. infertility); (2) continual failure of implantation at subsequent cycles of assisted reproductive technology; or (3) persistent miscarriage events without difficulty conceiving (natural conceptions). Tubal factor infertility is among the leading causes of female factor infertility accounting for 7-9.8% of all female factor infertilities. Tubal disease directly causes from 36% to 85% of all cases of female factor infertility in developed and developing nations respectively and is associated with polymicrobial aetiologies. One of the leading global causes of tubal factor infertility is thought to be symptomatic (and asymptomatic in up to 70% cases) infection of the female reproductive tract with the sexually transmitted pathogen, Chlamydia trachomatis. Infection-related damage to the Fallopian tubes caused by Chlamydia accounts for more than 70% of cases of infertility in women from developing nations such as sub-Saharan Africa (Sharma et al., 2009). Bacterial vaginosis, a condition associated with increased transmission of sexually transmitted infections including those caused by Neisseria gonorrhoeae and Mycoplasma genitalium is present in two thirds of women with pelvic inflammatory disease (PID). -
Population Attributable Fraction of Tubal Factor Infertility Associated with Chlamydia
HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Am J Obstet Manuscript Author Gynecol. Author Manuscript Author manuscript; available in PMC 2018 September 01. Published in final edited form as: Am J Obstet Gynecol. 2017 September ; 217(3): 336.e1–336.e16. doi:10.1016/j.ajog.2017.05.026. Population Attributable Fraction of Tubal Factor Infertility Associated with Chlamydia Rachel J. GORWITZ, MD, MPH1, Harold C. WIESENFELD, MD, CM2,3, Pai Lien CHEN, PhD4, Ms. Karen R. HAMMOND, DNP, CRNP5, Ms. Karen A. SEREDAY, MS1, Catherine L. HAGGERTY, PhD, MPH3,6, Robert E. JOHNSON, MD, MPH1, John R. PAPP, PhD1, Dmitry M. KISSIN, MD, MPH1, Tara C. HENNING, PhD1, Edward W. HOOK III, MD7, Michael P. STEINKAMPF, MD, MA5, Lauri E. MARKOWITZ, MD1, and William M. GEISLER, MD, MPH7 1Centers for Disease Control and Prevention, Atlanta, GA 2Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 3Magee-Womens Research Institute, Pittsburgh, PA 4FHI360, Durham, NC 5Alabama Fertility Specialists, Birmingham, AL 6Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA 7Department of Medicine, University of Alabama at Birmingham, Birmingham, AL Abstract Background—Chlamydia trachomatis infection is highly prevalent among young women in the United States. Prevention of long-term sequelae of infection, including tubal factor infertility, is a primary goal of chlamydia screening and treatment activities. However, the population attributable fraction of tubal factor infertility associated with chlamydia is unclear, and optimal measures for assessing tubal factor infertility and prior chlamydia in epidemiologic studies have not been established. Black women have increased rates of chlamydia and tubal factor infertility compared Corresponding author: Rachel J. -
Increased Prevalence of Endocervical Mycoplasma and Ureaplasma Colonization in Infertile Women with Tubal Factor
JBRA Assisted Reproduction 2020;24(2):152-157 doi: 10.5935/1518-0557.20190078 Original article Increased prevalence of endocervical Mycoplasma and Ureaplasma colonization in infertile women with tubal factor Rita CCP Piscopo1, Ronney V Guimarães1, Joji Ueno1,2, Fabio Ikeda1,2, Zsuzsanna IK Jarmy-Di Bella3, Manoel JBC Girão3, Marise Samama1,3 1Clinical Department, Instituto Gera de Medicina Reprodutiva, São Paulo, SP, Brazil 2Video-Hysteroscopy Section, Hospital Sírio Libanês, São Paulo, SP, Brazil 3Gynecology Department, Universidade Federal de São Paulo - Escola Paulista de Medicina, São Paulo, SP, Brazil This study was presented as a poster at the ESHRE Annual Meeting 2018, held in Barcelona – Spain on July 01-04, 2018 ABSTRACT damage seems to be the foremost way in which infections Objective: Most women suffering from tubal factor in- affect women’s fertility. Pathogenic microorganisms colo- fertility do not have a history of pelvic inflammatory dis- nizing the lower female genital tract may ascend to the ease, but rather have asymptomatic upper genital tract in- upper genital tract, causing pelvic inflammatory disease fection. Investigating the impacts of such infections, even (PID) associated with tubal damage, and ultimately to in- in the absence of clinically confirmed pelvic inflammatory fertility. In the presence of infection, tubal damage may disease, is critical to understanding the tubal factor of in- occur in response to adhesions, damage to the tubal mu- fertility. The aim of this study was to investigate whether cosa or tubal occlusion impairing oocyte transport (Rho- the presence of endocervical bacteria is associated with ton-Vlasak, 2000). tubal factors in women screened for infertility. -
Infertility: an Overview
AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE Infertility: An Overview A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of the Patient Education Committee and the Publications Committee. No portion herein may be reproduced in any form without written permission. This booklet is in no way intended to replace, dictate, or fully define evaluation and treatment by a qualified physician. It is intended solely as an aid for patients seeking general information on issues in reproductive medicine. Copyright © 2017 by the American Society for Reproductive Medicine AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE Infertility: An Overview A Guide for Patients, Revised 2017 A glossary of italicized words is located at the end of this booklet. INTRODUCTION Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. If you have been trying to conceive for a year or more, you should consider an infertility evaluation. However, if you are 35 years or older, you should consider beginning the infertility evaluation after about six months of unprotected intercourse rather than a year, so as not to delay potentially needed treatment. If you have a reason to suspect an underlying problem, you should seek care earlier. For instance, if you have very irregular menstrual cycles (suggesting that you are not ovulating or releasing an egg), or if you or your partner has a known fertility problem, you probably should not wait an entire year before seeking treatment. If you and your partner have been unable to have a baby, you’re not alone. -
Role of Tubal Surgery in the Era of Assisted Reproductive Technology: a Committee Opinion
ASRM PAGES Role of tubal surgery in the era of assisted reproductive technology: a committee opinion The Practice Committee of the American Society for Reproductive Medicine American Society for Reproductive Medicine, Birmingham, Alabama This document reviews surgical options for reparative tubal surgery and the factors that must be considered when deciding between surgical repair and in vitro fertilization. This document replaces the document of the same name, last published in 2012 (Fertil Steril 2015;103:e37–43). This document reviews surgical options for reparative tubal surgery and the factors that must be considered when deciding between surgical repair and in vitro fertilization. (Fertil SterilÒ 2021;115:1143–50. Ó2021 by American Society for Reproductive Medicine.) Key Words: Fallopian tube, hydrosalpinx, sterilization reversal, tubal disease Discuss: You can discuss this article with its authors and other readers at https://www.fertstertdialog.com/posts/32331 ubal disease accounts for 25%– mydia antibody testing is limited by raphy may have a therapeutic effect, T 35% of female factor infertility, false positives from cross-reactivity with higher fecundity rates reported with more than half of the cases with Chlamydia pneumoniae immuno- for several months after the procedure due to salpingitis (1). In addition, large globulin G and does not distinguish be- (11) when tubal flushing was performed studies report that up to 20%–30% of tween remote and persistent infection, with oil-based contrast media (11, 12). women regret having a tubal ligation and it does not indicate whether the The sensitivity of hysterosalpingo- (2–4). Thus, there is a need to infection resulted in tubal damage (5). -
Sexually Transmitted Diseases and Infertility
HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Am J Obstet Manuscript Author Gynecol. Author Manuscript Author manuscript; available in PMC 2018 January 01. Published in final edited form as: Am J Obstet Gynecol. 2017 January ; 216(1): 1–9. doi:10.1016/j.ajog.2016.08.008. Sexually Transmitted Diseases and Infertility Ms. Danielle G. TSEVAT, BA1, Harold C. WIESENFELD, MD2, Caitlin Parks, MD1, and Jeffrey F. PEIPERT, MD, PhD3 1Washington University in St. Louis School of Medicine, Division of Clinical Research Department of Obstetrics and Gynecology 2Division of General Gynecology, Department of Obstetrics and Gynecology; University of Pittsburgh School of Medicine; Pittsburgh, PA 3Department of Obstetrics and Gynecology; Indiana University School of Medicine; Indianapolis, IN Abstract Female infertility, including tubal factor infertility, is a major public health concern worldwide. Most cases of tubal factor infertility are attributable to untreated sexually transmitted diseases that ascend along the reproductive tract and are capable of causing tubal inflammation, damage, and scarring. Evidence has consistently demonstrated the effects of Chlamydia trachomatis and Neisseria gonorrhoeae as pathogenic bacteria involved in reproductive tract morbidities including tubal factor infertility and pelvic inflammatory disease. There is limited evidence in the medical literature that other sexually transmitted organisms, including Mycoplasma genitalium, Trichomonas vaginalis, and other microorganisms within the vaginal microbiome may be important factors involved in the pathology of infertility. Further investigation into the vaginal microbiome and other potential pathogens is necessary in order to identify preventable causes of tubal factor infertility. Improved clinical screening and prevention of ascending infection may provide a solution to the persistent burden of infertility. -
Pelvic Inflammatory Disease
The new england journal of medicine Review Article Edward W. Campion, M.D., Editor Pelvic Inflammatory Disease Robert C. Brunham, M.D., Sami L. Gottlieb, M.D., M.S.P.H., and Jorma Paavonen, M.D. elvic inflammatory disease is an infection-induced inflammation From the Department of Medicine, Uni- of the female upper reproductive tract (the endometrium, fallopian tubes, versity of British Columbia, Vancouver, 1 Canada (R.C.B.); the Department of Re- ovaries, or pelvic peritoneum); it has a wide range of clinical manifestations. productive Health and Research, World P Health Organization, Geneva (S.L.G.); Inflammation spreads from the vagina or cervix to the upper genital tract, with endometritis as an intermediate stage in the pathogenesis of disease.2 The hall- and the Department of Obstetrics and Gynecology, University of Helsinki, Hel- mark of the diagnosis is pelvic tenderness combined with inflammation of the sinki (J.P.). Address reprint requests to lower genital tract; women with pelvic inflammatory disease often have very subtle Dr. Brunham at the Department of Medi- symptoms and signs.3 Many women have clinically silent spread of infection to the cine, University of British Columbia, 655 1,4 West 12th Ave., Vancouver, BC V5Z 4R4, upper genital tract, which results in subclinical pelvic inflammatory disease. Canada, or at robert . brunham@ bccdc . ca. Pelvic inflammatory disease is a major concern because it can result in long- N Engl J Med 2015;372:2039-48. term reproductive disability, including infertility, ectopic pregnancy, and chronic DOI: 10.1056/NEJMra1411426 pelvic pain. After the introduction of laparoscopy in the 1960s, research on pelvic in- Copyright © 2015 Massachusetts Medical Society. -
Fertility Solutions Medical Necessity Clinical Guideline: Infertility
Clinical Performance Guideline Medical Fertility Solutions Necessity Infertility Guideline TABLE OF CONTENTS PURPOSE AND GOAL 2 BACKGROUND 2 GENERAL INDICATIONS 9 TREATMENT CRITERIA 10 OVULATION INDUCTION 10 CLOMID 10 LETROZOLE 10 TAMOXIFEN 11 GONADOTROPINS 11 OVARIAN STIMULATION 12 CLOMID 12 LETROZOLE 12 TAMOXIFEN 12 GONADOTROPINS 13 THERAPEUTIC DONOR INSEMINATION 14 INTRAUTERINE INSEMINATION 15 NATURAL CYCLE 15 STIMULATED IUI 15 ASSISTED REPRODUCTIVE TECHNOLOGIES 16 IVF 16 NATURAL CYCLE IVF 17 ICSI 17 IVF FRESH CYCLE NOT INDICATED 18 ELECTIVE SINGLE EMBRYO TRANSFER 19 MULTIPLE EMBRYO TRANSFER 20 ADJUNCTS TO TREATMENT 21 PREIMPLANTATION GENETIC TESTING 21 GESTATIONAL CARRIER 21 SURGERY 22 TUBAL 22 ENDOMETRIOSIS 23 UTERINE 24 MALE FACTOR INFERTILITY 24 DEFINITIONS 39 BIBLIOGRAPHY 41 This document is proprietary and confidential to Optum® 2021. Effective 07/01/2021 . Unauthorized use or copying without written consent is strictly prohibited. Printed copies are for reference only. TABLE OF CONTENTS 1 Purpose: To provide an understanding of infertility treatment, issues surrounding infertility surgery, and issues surrounding multiple embryo transfers among individuals faced with the potential loss of fertility. Goals: To provide an evidence-based approach to infertility management, infertility surgery, and the use of single embryo transfer in addition to describing the limitations of and recommendations for infertility treatment. Background I. Infertility • Definition: o A disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery. It is defined by the failure to achieve a successful pregnancy after 12 months or more of appropriate, timed unprotected intercourse or Therapeutic Donor Insemination. -
Genital Tuberculosis Is Common Among Females with Tubal Factor Infertility: Observational Study
Alexandria Journal of Medicine (2015) 51, 321–324 HOSTED BY Alexandria University Faculty of Medicine Alexandria Journal of Medicine http://www.elsevier.com/locate/ajme Genital tuberculosis is common among females with tubal factor infertility: Observational study Abdulhakim Ali Al eryani a, Ahmed Saleh Abdelrub b, Abdelrahman H. Al Harazi c,* a Obstetrics and Gynecology Department, Sana’a University, Al Thawra General Hospital, Sana’a, Yemen b Obstetrics and Gynecology Department, Al Kwait University Hospital, Sana’a, Yemen c Obstetrics and Gynecology Department, Thamar University, Al Thawra General Hospital, PO Box 25244, Yemen Received 17 September 2014; accepted 27 November 2014 Available online 2 January 2015 KEYWORDS Abstract Background: Genital tuberculosis is mostly asymptomatic and infertility is a common Genital tuberculosis; presentation. The study objective was to identify the rate of genital tuberculosis among women with Infertility; tubal factor infertility in non endemic area and to assess the outcome after administration of anti- Polymerase chain reaction tubercular therapy. Methods: We conducted a prospective observational study in Al Thawra General Hospital (from March 2012 to February 2014). Of a total 151 women who had tubal factor infertility, 61 cases were investigated for genital tuberculosis. Women who were found to have the disease were treated by antitubercular therapy and the outcomes were analyzed. Results: We found that 31.1% (47/151) of cases had genital tuberculosis contributing to infertility. Of these, 55.7% (34/61) were positive by histopathology, and 44.1% (15/34) were positive by poly- merase chain reaction. Fallopian tubes were affected in almost all cases and the endometrium was involved in 82.9%. -
2013 ART Fertility Clinic Success Rates Report
2013Appendix B Glossary of Terms APPENDIX B: GLOSSARY OF TERMS American Society for Reproductive Medicine Donor egg cycle. An embryo is formed from (ASRM). Professional society whose affiliate the egg of one woman (the donor) and then organization, the Society for Assisted Reproductive transferred to another woman (the recipient). Technology (SART), is composed of clinics and The donor relinquishes all parental rights to any programs that provide ART. resulting offspring. ART (assisted reproductive technology). All Donor embryo. An embryo that is donated by a treatments or procedures that include the handling patient or couple who previously underwent ART of human eggs or embryos to help a woman treatment and had extra embryos available. become pregnant. ART includes but is not limited Ectopic pregnancy. A pregnancy in which the to in vitro fertilization (IVF), gamete intrafallopian fertilized egg implants in a location outside of the transfer (GIFT), zygote intrafallopian transfer uterus—usually in the fallopian tube, the ovary, (ZIFT), tubal embryo transfer, egg and embryo or the abdominal cavity. Ectopic pregnancy is a cryopreservation, egg and embryo donation, and dangerous condition that must receive prompt gestational surrogacy. medical treatment. ART cycle. An ART cycle starts when a woman Egg. A female reproductive cell, also called an begins taking fertility drugs or having her ovaries oocyte or ovum. monitored for follicle production. If eggs are produced, the cycle progresses to egg retrieval. Egg/Embryo banking cycle. An ART cycle started Retrieved eggs are combined with sperm to create with the intention of freezing (cryopreserving) all embryos. If fertilization is successful, at least one resulting eggs or embryos for potential future use.