Tingginya Infeksi Chlamydia trachomatis pada Kerusakan Tuba Fallopi Wanita Infertil
Downloads
Tujuan: Untuk mengetahui gambaran infeksi C. trachomatis pada kerusakan tuba fallopi wanita infertil.
Bahan dan Metode: Penelitian ini melibatkan 42 wanita yang menjalani laparoskopi dalam tata laksana infertilitasnya. Infeksi C. trachomatis diperiksa menggunakan metode PCR dari usapan endoserviks dan IgG C. trachomatis diperiksa menggunakan metode ELISA dari darah vena. Kondisi tuba fallopi dilakukan evaluasi saat laparoskopi.
Hasil: Didapatkan C. trachomatis sebesar 14,29% dari PCR usapan endoserviks dan 38,10% dari IgG C. trachomatisdi darah. Sebagian besar tuba fallopi pada subyek dengan infeksi C. trachomatis menunjukkan kerusakan, ditandai adanya adhesi perituba, oklusi tuba, fimosis fimbria atau hidrosalping saat laparoskopi. IgG C. trachomatis berbeda signifikan pada kerusakan tuba fallopi (p = 0. 01), sedangkan endometriosis dan riwayat operasi sebagai faktor risiko tidak didapatkan perbedaan yang signifikan (p = 0. 26 dan p = 0. 27). Subyek dengan IgG C. trachomatis memiliki OR: 5. 5 (95% CI 1. 42-21. 7)untuk terjadi kerusakan tuba fallopi. IgG C. trachomatis memiliki sensitifitas 62,5%, spesifisitas 81,25%, PPV 62,5% dan NPV 81,25% dalam mendeteksi kerusakan tuba fallopi bila dikonfirmasi dengan hasil laparoskopi.
Simpulan: Angka kejadian infeksi C. trachomatis pada wanita infertil cukup tinggi. Pemeriksaan IgG C. trachomatis dapat menjadi penanda adanya kerusakan tuba fallopi.Akande VA. Tubal pelvic damage: prediction and prognosis. Hum Fertil. 2002;5(1):15-20.
Patton DL, Sweeney YC, Kuo C. Demonstration of Delayed Hypersensitivity in Chlamydia trachomatis Salpingitis in Monkeys: A Pathogenic Mechanism of Tubal Damage. J Infect Dis. 1994;169:680-3.
Brunham RC, Rey-Ladino. Immunology of Chlamydia infection: implications for a Chlamydia trachomatis vaccine. Nature reviews immunology. 2005;5:140-61.
Wilson JS, Honey E, Templeton A, Paavonen J, Mardh PA, Stary A, et al. A systematic review of the prevalence of Chlamydia trachomatis among European women. Hum Reprod Update. 2002;28: 385-94.
Rashidi BH, Chamani-Tabriz L, Haghollahi F, Jeddi-Tehrani M, Naghizadeh MM, Shariat M, et al. Effects of Chlamydia trachomatis Infection on Fertility; A Case-Control Study. J Reprod Infertil. 2013;14(2):67-72.
Jeremiah I, Okike O, Akani C. The prevalence of serum immunoglobulin G antibody to Chlamydia trachomatis in subfertile women presenting at the University of Port Harcourt teaching hospital, Nigeria. Int J Biomed Sci. 2011;7(2):120-4.
Tanudyaya FK, Rahardjo E, Bollen LJM, Madjid N, Daili SF, et al. Prevalence of sexually transmitted infections and sexual risk behavior among female sex workers in nine provinces in Indonesia. Southeast Asian J Trop Med Public Health. 2010;41(2):463-73.
Lumintang H, Murtiastutik D, Saptandari P, Merthaniasih NM, Samsulhadi. Study on chlamydial lower genital tract infection among female adolescents in Surabaya. 2004.
Hinting A, Soehartono, Barakbah J, Ernawan Y, Lunardhi H, Winarso H, et al. Prevalence of chlamydial urethral infection in male university students in Surabaya. 2005.
Sari DW. Insidensi Chlamydia trachomatis pada servisitis dengan keluhan dan tanpa keluhan berdasar pemeriksaan Reaksi Rantai Polimerasi (RRP). 2008.
Hiroi H, Fujiwara T, Nakazawa M, Osuga Y, Momoeda M, et al. High incidence of tubal dysfunction is determined by laparoscopy in cases with positive Chlamydia trachomatis antibody despite negative finding in prior hysterosalping-ography. Reproductive Medicine and Biology. 2007;6:39-43.
Rashidi BH, Chamani-Tabriz L, Haghollahi F, Jeddi-Tehrani M, Naghizadeh MM, Shariat M, et al. Effects of Chlamydia trachomatis Infection on Fertility; A Case-Control Study. J Reprod Infertil. 2013;14(2):67-72.
Dhawan B, Rawre J, Ghosh A, Malhotra N, Ahmed MM, Sreenivas V, Chaudhry R. Diagnostic efficacy of a real time-PCR assay for Chlamydia tracho-matis infection in infertile women in north India. Indian J Med Res. 2014;140:252-61.
Dielissen PW, Teunissen DM, Lagro-Janssen TM. Chlamydia prevalence in the general population: is there a sex difference? A systematic review. BMC Infectious Diseases. 2013;13:534.
Westrom L, Joesoef R, Reynolds G, Hadgu A, Thompson SE. Pelvic inflammatory disease and fertility: a cohort study of 1,844 women with lapar-oscopically verified disease and 657 control women with normal laparoscopy results. Sex Transm Dis. 1992;19:185-92.
Neuer A, Spandorfer SD, Giralso P, et al. The role of heat shock proteins in reproduction. Hum Reprod Update. 2000;6:149-59.
Witkin SS, Sultan KM, Neal JJ, et al. Unsuspected Chlamydia trachomatis infection and in vitro fertilization outcome. Am. J. Obstet. Gynecol. 1994;171:1208.
Camus E, Poncelet C, Goffinet F, Wainer B, Merlet F, Nisand I and Philippe HJ. Pregnancy rates after in-vitro fertilization in cases of tubal infertility with and without hydrosalpinx: a meta-analysis of published comparative studies. Human Reproduct-ion. 1999;14(5):1243-9.
Jeremiah I, Okike O, Akani C. The Prevalence of Serum Immunoglobulin G Antibody to Chlamydia trachomatis in Subfertile Women Presenting at the University of Port Harcourt Teaching Hospital, Nigeria. Int J Biomed Sci. 2011;7 (2):120-4.
Malik A, Jain S, Hakim S, Shukla I and Rizvi M. Chlamydia trachomatis infection & female infertility. Indian J Med Rea. 2006;123:770-5.
Hartog JE, Land JA, Stassen FRM, Kessels AGH, Bruggeman CA. Serological markers of persistent C. trachomatis infections in women with tubal factor subfertility. Hum Reprod. 2005;20(4):986-90.
Kodaman PH, Arici A, Seli E. Evidence-based diagnosis and management of tubal factor infertility. Curr Opin Obst Gynecol. 2004;16:221-9.
Halis G, Arici A. Endometriosis and Inflammation in Infertility. Ann N Y Acad Sci. 2004;1034:300-15.
Mol BW, Dijkman B, Wertheim P, Lijmer J, van der Veen F and Bossuyt PM. The accuracy of serum chlamydial antibodies in the diagnosis of tubal pathology: a meta-analysis. Fertil Steril. 1997;67:1031-7.
1. Copyright of the article is transferred to the journal, by the knowledge of the author, whilst the moral right of the publication belongs to the author.
2. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution-Non Commercial-Share alike (CC BY-NC-SA), (https://creativecommons.org/licenses/by-nc-sa/4.0/)
3. The articles published in the journal are open access and can be used for non-commercial purposes. Other than the aims mentioned above, the editorial board is not responsible for copyright violation
The manuscript authentic and copyright statement submission can be downloaded ON THIS FORM.