The accuracy of serum chlamydial antibodies in the diagnosis of tubal pathology: a meta-analysis.

Abstract:

OBJECTIVE:To assess the discriminative capacity of Chlamydia antibody titers in the diagnosis of tubed pathology in subfertile patients. DESIGN:Meta-analysis of studies comparing Chlamydia antibody titers and laparoscopy for tubal patency and peritubal adhesions. PATIENTS:A total of 2,729 patients with subfertility in 23 studies. INTERVENTION(S):Chlamydia antibody titer and laparoscopy as part of subfertility work-up. MAIN OUTCOME MEASURE:Sensitivity and specificity of Chlamydia antibody titers in the diagnosis of tubal pathology using laparoscopy with chromopertubation as the reference standard. RESULT(S):The discriminative capacity of Chlamydia antibody titers depended on the type of assay that was used. Summary receiver operating characteristic (ROC) curves of studies using ELISA or (micro)immunofluorescence revealed a better discrimination than the summary ROC-curve of studies using immunoperoxidase assay. CONCLUSION(S):The discriminative capacity of Chlamydia antibody titers by means of ELISA, microimmunofluorescence, or immunofluorescence in the diagnosis of any tubal pathology is comparable to that of hysterosalpingography (HSG) in the diagnosis of tubal occlusion. Chlamydia antibody testing involves little burden but provides no details on the anatomy of uterus and tubes. Whether or not Chlamydia antibody testing can replace HSG depends on the perspective taken in the diagnostic work-up of subfertility.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Mol BW,Dijkman B,Wertheim P,Lijmer J,van der Veen F,Bossuyt PM

doi

10.1016/s0015-0282(97)81435-5

subject

Has Abstract

pub_date

1997-06-01 00:00:00

pages

1031-7

issue

6

eissn

0015-0282

issn

1556-5653

pii

S0015028297814355

journal_volume

67

pub_type

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