What is the excess risk of infertility in women after genital chlamydia infection? A systematic review of the evidence

Wallace, L.A., Scoular, A., Hart, G., Reid, M., Wilson, P. and Goldberg, D.J. (2008) What is the excess risk of infertility in women after genital chlamydia infection? A systematic review of the evidence. Sexually Transmitted Infections, 84, pp. 171-175. (doi: 10.1136/sti.2007.026047)

Abstract

Methods: Twelve databases were searched, limited to peer-reviewed literature published from January 1970 to September 2007. Conference abstracts and reference lists from reviews published since 2000 and from key articles were hand-searched. Studies were selected for review if they met the following criteria: (1) the study population comprised women of child-bearing age (defined as 15–45 years) and incorporated a comparison group of women documented as "chlamydia negative"; (2) the study outcomes included either infertility or successful pregnancy; and (3) the study design was one of the following: cohort, randomised controlled trial, "before and after" study, screening trial and systematic review. Studies were excluded if they described genital infections that either did not include Chlamydia trachomatis or described genital chlamydial co-infection, in which no data were available for C trachomatis infection alone. Results: 3349 studies were identified by the search. One study satisfied the inclusion criteria, a longitudinal investigation measuring pregnancy rates in adolescent women with and without current chlamydial infection at baseline. That study reported no significant difference in subsequent pregnancy rates; however, it had serious methodological limitations, which restricted its conclusions. Conclusions: This systematic review demonstrates the absence of valid evidence on the attributable risk of post-infective tubal factor infertility after genital chlamydial infection. The findings contribute empirical data to the growing debate surrounding previous assumptions about the natural history of chlamydial infection in women.

• Item Type: Articles
• Keywords: chlamydia infections, natural history, infertility, screening programme, health policy
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Wilson, Prof Philip and Hart, Prof Graham and Reid, Professor Margaret and Scoular, Dr Anne and Goldberg, Prof David
• Authors: Wallace, L.A., Scoular, A., Hart, G., Reid, M., Wilson, P., and Goldberg, D.J.
• Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Journal Name: Sexually Transmitted Infections
• Publisher: BMJ
• ISSN: 1368-4973
• Copyright Holders: Copyright © 2008 BMJ
• First Published: First published in Sexually Transmitted Infections 84:171-175
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher