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.