Impact of Genital Chlamydia Trachomatis Infection in Women Presenting with Infertility in Lagos, Nigeria

Background: Chlamydia trachomatis is an obligate intracellular bacterial pathogen that has been implicated in a wide spectrum of human reproductive diseases including infertility. Many studies have confirmed the association of Chlamydia trachomatis with tubal infertility. However, there is a paucity of information on its contribution to various other types of infertility including unexplained infertility. The available studies on the association of chlamydia with infertility are serology based.

Objectives: Using nucleic acid amplification test (NAAT), this study determined the association between Chlamydia trachomatis infection and infertility in women attending the infertility clinic of the Lagos University Teaching Hospital.

Methods: This was an analytical cross- sectional study conducted among reproductive age women with infertility and an equal number of fertile women attending the Lagos University Teaching Hospital. Chlamydia trachomatis detection test (NAAT) was done using laboratory protocol comprising nucleic acid amplification test Data analysis was performed using the EPI-INFO version 7.2 statistical software, with appropriate statistics and associations carried out.

Results: The prevalence of chlamydia trachomatis infection was 10% in infertile participants but 1.7% in the fertile comparative group (P=0.057). There were statistically significant differences in age (p = 0.016) and parity (p= <0.001) of women in the two comparison groups. Chlamydia trachomatis infection positivity was higher in women in the third decade of life on multivariate analysis (p = 0.008). Half of the women with infertility that tested positive for chlamydia trachomatis infection in this study had tubal factor while the other half had unexplained infertility.

Conclusion: This study showed a higher prevalence of Chlamydia trachomatis infection in women with infertility as compared with women with spontaneous intrauterine pregnancy. There was no association between active Chlamydia trachomatis infection and infertility.