Decreased occurrence of endometriosis in women with Chlamydia trachomatis infection

Khan KN, Fujishita A, Kitajima M, Ishimaru T, Ogawa K, Koshiba A, Mori T, Kitawaki J · American Journal of Reproductive Immunology · 2021 September 23

DOI 10.1111/aji.13498

Objective

To investigate the role of Chlamydia trachomatis infection, with or without fallopian tubal patency, in the occurrence of endometriosis.

Conclusions

In a retrospective case-controlled cohort study with 207 women who had laparoscopic surgery, chlamydia infection was associated with a significant decrease in tubal patency and the occurrence of endometriosis. Even among women with patent tubes, laparoscopic detection of endometriosis was significantly decreased in those with chlamydia infection. The study suggests that a previous history of chlamydia infection significantly decreases the occurrence of endometriosis, independent of age, menstrual status, parity, and tubal patency.

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Insights

Chlamydia trachomatis infection, particularly when causing fallopian tube obstruction, may decrease the risk of developing endometriosis in women.

The study is a retrospective case-controlled cohort study focusing on 539 women who had laparoscopic surgery for varied reasons between January 2003 and June 2010. The study excluded women having ectopic pregnancy, chromosomal abnormality, primary amenorrhea, perimenopausal women and those with uterine anomaly. Endometriosis and tubal patency were diagnosed through laparoscopic inspection, histopathology, HSG or laparoscopic chromopertubation test. Furthermore, Chlamydia infection was verified using RT-PCR and a serological test. Out of the 207 women enrolled, 86 women were confirmed to have Chlamydia infection. The study discovered a significant decrease in the occurrence of endometriosis amongst women with Chlamydia infection, when compared to those without. The decreased rate of endometriosis was also found in Chlamydia-infected women with patent tubes. It was derived from the study that a previous history of Chlamydia infection could potentially decrease the risk of endometriosis, independent of factors like age, menstrual status, tubal patency, and parity.