Antichlamydial Antibodies, Human Fertility, and Pregnancy Wastage

Table 1

Role of antichlamydial antibody testing in male and female fertility.

	Method	Sens. (%)	Specif. (%)	PPV (%)	NPV (%)	Utility in females	Utility in males
CT IgG [22]	ELISA	72.7	77.7	—	—	Presence indicates previous or persistent C. trachomatis infection; associated with tubal damage; increased titers associated with more severe tubal damage; sens./specif. may be increased with the addition of HSG or laparoscopy	—
CT IgG [33]	ELISA	43.2	86.5	63.3	73.8		—
CT IgG [6]	MIF	74	93	94.8	69.8		—
CT IgG [5]	EIA	45	83	—	—		—
CT IgG [23] Titer >1 : 256	WIF	69	85	78	78		—
CT HSP60 [33]	ELISA	59.1	77.9	59.1	77.9	Reflects chronic C. trachomatis infection; predicts TFI	—
CT HSP60 [7]	GST ELISA	56	95	—	—	Higher titers related to increased severity of tubal damage	—
+ClpP Ab [7]	GST ELISA	69	—	92	79	Improve sens./specif. in Ab based diagnosis of TFI	—
CT IgA [28, 29]	MIF/EIA	—	—	—	—	—	Reduces chances of achieving pregnancy; reduced motility of spermatozoa, increased number of dead spermatozoa
+CT IgG [28, 29]	MIF/EIA	—	—	—	—	—	Further reduce pregnancy rates, decrease sperm concentration, decrease number of progressive spermatozoa
CT HSP60 [29]	ELISA	—	—	—	—	—	Reduce spermatozoa motility

ELISA: enzyme-linked immunosorbent assay, EIA: enzyme immunoassay, WIF: whole-cell inclusion immunofluorescence assay, GST ELISA: glutathione S-transferase ELISA, MIF: microimmunofluorescence, Ab: antibody; Sens.: sensitivity, Specif.: specificity, PPV: positive predictive value, NPV: negative predictive value; TFI: tubal factor infertility; HSG: hysterosalpingogram.