The prevalence of Chlamydia trachomatis infection among Saudi women attending the infertility clinic in Central Saudi Arabia

Objectives:

To determine the prevalence of Chlamydia trachomatis (C. trachomatis) infection among Saudi women, its clinical presentation, and its association to infertility.

Methods:

This study was conducted between October 2012 and July 2013 at King Khalid University Hospital and King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia. Female patients aged between 19 and 46 years old with infertility problems seen at both hospitals were recruited to join the study. A separate group of female patients without infertility problems was also recruited from both hospitals to serve as controls for the study. Endocervical swabs were collected from both groups of patients, and samples were analyzed using real time polymerase chain reaction.

Results:

There was a statistically significantly greater prevalence of C. trachomatis infection in infertile women (n=8, 8.0%) compared with the fertile group of women (n=1, 1.0%). The C. trachomatis infection was significantly correlated to infertility.

Conclusion:

A significant association between infertility and increased prevalence of C. trachomatis infection is shown in this study, thus, we suggest that screening for Chlamydial infection to be part of the routine investigation for infertility.Infertility is a worldwide health problem among couples with approximately 15% current global infertility rate, translating to one in 6 couples suffering from this condition.1 It is a public health problem with a major economic impact on the health care system in many countries.2 According to the World Health Organization, there is an estimated 448 million new cases of sexually transmitted infections (STI’s) which are acquired worldwide annually.3 There is a multitude of bacterial, viral, and parasitic pathogens that are transmissible sexually.4Chlamydia trachomatis (C. trachomatis) is a gram-negative bacteria and is one the most frequently reported STI. It has 3 human serovars; serovar Ab, B, Ba or C, which causes trachoma (an eye infection), serovar D to K which causes pelvic inflammatory diseases (PID), ectopic pregnancy and urethritis, and serovars La to L3 which causes lymphogranuloma venereum (LGV).5-9 The C. trachomatis is increasingly being associated with long-term complications, such as asymptomatic endometritis, cervicitis, PID, and tubal factor infertility.5-9 The association between C. trachomatis infection and infertility has been the subject of several research. A study in Iran10 suggested the significant association between C. trachomatis infection and female infertility with a prevalence rate of 15.3%. The same finding was suggested by a study conducted in India, which confirmed the significant association between infertility and the duration of C. trachomatis infection.11 Furthermore, another study suggested that a positive serology screening result for C. trachomatis is predictive for both tubal damage, and a reduced pregnancy rate.12 A prevalence rate of 9.6% was found in female patients attending the infertility clinic in a study carried out in Nigeria.13 Other prevalence rates include studies carried out in the USA (5-15% prevalence rate),8,14 UK (16%),15 Jordan (3.9%),16 Iran (22%),17 and Brazil (10.9%).18 We conducted this study to determine the prevalence of C. trachomatis infection among women attending the infertility clinic in 2 tertiary hospitals in Central Saudi Arabia.