The purpose of the study was to determine whether serologic studies for Chlamydia would be helpful in identifying cases in which a tubal factor is responsible for
infertility. One hundred and fourteen infertile women, consecutive patients who came to the infertility clinic at the University of Texas Medical Branch at Galveston, had serological tests for Chlamydia and subsequent tubal evaluations by laparoscopy or
laparotomy. Seventy-four patients (65%) had positive titers for Chlamydia, of whom 57 (77%) were found to have
tubal obstruction. Forty-four had distal
tubal obstruction; three had cornual obstruction; and ten had peritubal adhesions. Of the 40 patients with negative titers for Chlamydia, only 14 (35%) were found to have
tubal obstruction. The difference in the incidence of tubal disease between women with positive titers and those with negative titers was statistically significant (P less than .002). A significant correlation (P less than .001) was observed between the prevalence of
antibodies and distal
tubal obstruction. Of the 74 patients with positive titers, 48 (65%) had no history of prior symptomatic
pelvic inflammatory disease. These findings suggest that chlamydial
infection, as evidenced by positive antibody titers, is associated with a significantly high incidence of tubal
infertility and that in the majority of these patients, the prior
infection was subclinical and asymptomatic.