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First‐trimester pregnancy loss and active Chlamydia trachomatis infection: correlation and ultrastructural evidence
Author(s) -
Vigil P.,
Tapia A.,
Zacharias S.,
Riquelme R.,
Salgado A. M.,
Varleta J.
Publication year - 2002
Publication title -
andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.633
H-Index - 59
eISSN - 1439-0272
pISSN - 0303-4569
DOI - 10.1046/j.1439-0272.2002.00520.x
Subject(s) - chlamydia trachomatis , abortion , incidence (geometry) , pregnancy , andrology , medicine , pathogenesis , gynecology , chlamydia , obstetrics , biology , immunology , genetics , physics , optics
Summary. The incidence of Chlamydia trachomatis (Ct) infection and the possible correlation between couples presenting with first‐trimester spontaneous abortions and active Ct infection was assessed. Additionally, the ability of Ct to infect zona‐free hamster oocytes was explored by incubating the oocytes with spermatozoa from infected patients. A total of 961 women and 750 men consulting our reproductive medicine centre were screened for Ct using direct immunofluorescence. The general incidence of Ct infection was 9.4% in females (90 of 961) and 13.9% in males (104 of 750). In women with spontaneous abortions the incidence of Ct was 21.0% (14 of 66) compared with 8.9% (23 of 59) for women without spontaneous abortions and term pregnancies (chi‐square, P < 0.05). When both partners of the couples were considered (one or both partners infected), the incidence rose to 68.8% (22 of 32) (chi‐square, P < 0.001). In vitro studies using electron microscopy demonstrated the presence of Ct on the surface of and inside the oocyte. These results indicate a correlation between an active Ct infection and spontaneous abortion. Electron microscopy studies suggested the possibility of direct oocyte infection by Ct. Two models are proposed for the pathogenesis of Ct‐related early abortions: (i) direct zygote infection, and (ii) immune response to heat shock proteins expressed by the zygote and triggered by previous Ct infections.