Hysterosalpingographic Findings in Chlamydia Trachomatis IgG-Positive Infertile Women Attending the Gynaecological Clinic in Abuja. Nigeria
Iyellobu Collins Ekhaesomi and Offor Juliet Oluchukwu*
ABSTRACT
Background: Chlamydia trachomatis infection is one of the most prevalent sexually transmitted infections worldwide and is frequently asymptomatic, allowing chronic inflammation to result in tubal and endometrial damage with subsequent infertility. In low-resource settings, accessible screening tools are required to identify women at risk of upper genital tract pathology.
Objective: To investigate hysterosalpingographic tubal and uterine findings and identify predictors of tubal occlusion among Chlamydia trachomatis IgG–positive infertile women attending the Federal Medical Centre, Abuja, Nigeria.
Methods: This prospective cross-sectional study included 130 infertile women aged 15–49 years with serological evidence of prior Chlamydia trachomatis exposure detected using a rapid chromatographic anti-Chlamydia IgG immunoassay (ACRO BIOTECH Inc., USA). All participants underwent hysterosalpingography on day 10 of the menstrual cycle. Descriptive statistics and multivariate logistic regression were used to assess factors associated with tubal occlusion.
Results: Secondary infertility accounted for 53.1% of cases. Tubal occlusion was observed in 76.9% of participants, while uterine synechiae were detected in 26.9%. Women with uterine synechiae had a fourfold increased likelihood of tubal occlusion (OR = 4.00; 95% CI: 1.68–9.52; p = 0.002). Increasing age, early sexual debut, multiple lifetime sexual partners, lower social class, and uterine synechiae were independently associated with tubal occlusion (p ≤ 0.05).
Conclusion: A high burden of tubal and uterine pathology was identified among Chlamydia trachomatis IgG–positive infertile women. Chlamydia serology may serve as a useful adjunctive screening tool for identifying women at increased risk of upper genital tract pathology in resource-constrained settings.
