Can history, ultrasound, or ELISA chlamydial antibodies, alone or in combination, predict tubal factor infertility in subfertile women?

Susan Logan, R. Gazvani, Hamish McKenzie, Alexander Allan Templeton, Siladitya Bhattacharya

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: This study aimed to determine whether medical history, transvaginal ultrasound (TVU) or Chlamydia trachomatis antibody testing (CAT), alone or in combination, could provide a non-invasive, clinically useful screening test for predicting tubal factor infetility (TFI) in subfertile women. Methods: Prior to tubal evaluation, relevant medical history, TVU findings, and enzyme-linked immunosorbet assay (ELISA) IgG CAT results were collected. Sensitivity, specificity, likelihood ratios (LR) and accuracy for predicting TFI, as determined by laparoscopy and dye hydrotubation, were calculated for each test alone, and in parallel and series combination. Results: Thirty per cent (63/207) were diagnosed with TFI. The highest sensitivity (67%, 95% CI: 54-77) included any positive test, yet missed one in three women with TFI. The highest specificity (100%, 95% CI: 97-100) required all three tests positive, but identified only three women. Only the combination of CAT and TVU rated as a good clinical test, but confidence intervals were wide due to the small numbers affected. The combination of CAT or TVU and CAT alone reported the highest accuracy (73%, 95% CI: 66-78), misdiagnosing one in four women. Conclusion: Medical history, TVU appearances, and ELISA IgG CAT alone, or in combination, failed to predict accurately TFI in subfertile women.

Original languageEnglish
Pages (from-to)2350-2356
Number of pages6
JournalHuman Reproduction
Volume18
Issue number11
DOIs
Publication statusPublished - Nov 2003

Keywords

  • Chlamydia trachomatis antibody test
  • medical history
  • subfertility
  • transvaginal ultrasound
  • tubal infertility
  • TRANSVAGINAL ULTRASONOGRAPHY
  • WORK-UP
  • TRACHOMATIS
  • HYSTEROSALPINGOGRAPHY
  • LAPAROSCOPY
  • DIAGNOSIS
  • COMPLICATIONS
  • METAANALYSIS
  • PATHOLOGY
  • ACCURACY

Cite this

Can history, ultrasound, or ELISA chlamydial antibodies, alone or in combination, predict tubal factor infertility in subfertile women? / Logan, Susan; Gazvani, R.; McKenzie, Hamish; Templeton, Alexander Allan; Bhattacharya, Siladitya.

In: Human Reproduction, Vol. 18, No. 11, 11.2003, p. 2350-2356.

Research output: Contribution to journalArticle

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T1 - Can history, ultrasound, or ELISA chlamydial antibodies, alone or in combination, predict tubal factor infertility in subfertile women?

AU - Logan, Susan

AU - Gazvani, R.

AU - McKenzie, Hamish

AU - Templeton, Alexander Allan

AU - Bhattacharya, Siladitya

PY - 2003/11

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N2 - Background: This study aimed to determine whether medical history, transvaginal ultrasound (TVU) or Chlamydia trachomatis antibody testing (CAT), alone or in combination, could provide a non-invasive, clinically useful screening test for predicting tubal factor infetility (TFI) in subfertile women. Methods: Prior to tubal evaluation, relevant medical history, TVU findings, and enzyme-linked immunosorbet assay (ELISA) IgG CAT results were collected. Sensitivity, specificity, likelihood ratios (LR) and accuracy for predicting TFI, as determined by laparoscopy and dye hydrotubation, were calculated for each test alone, and in parallel and series combination. Results: Thirty per cent (63/207) were diagnosed with TFI. The highest sensitivity (67%, 95% CI: 54-77) included any positive test, yet missed one in three women with TFI. The highest specificity (100%, 95% CI: 97-100) required all three tests positive, but identified only three women. Only the combination of CAT and TVU rated as a good clinical test, but confidence intervals were wide due to the small numbers affected. The combination of CAT or TVU and CAT alone reported the highest accuracy (73%, 95% CI: 66-78), misdiagnosing one in four women. Conclusion: Medical history, TVU appearances, and ELISA IgG CAT alone, or in combination, failed to predict accurately TFI in subfertile women.

AB - Background: This study aimed to determine whether medical history, transvaginal ultrasound (TVU) or Chlamydia trachomatis antibody testing (CAT), alone or in combination, could provide a non-invasive, clinically useful screening test for predicting tubal factor infetility (TFI) in subfertile women. Methods: Prior to tubal evaluation, relevant medical history, TVU findings, and enzyme-linked immunosorbet assay (ELISA) IgG CAT results were collected. Sensitivity, specificity, likelihood ratios (LR) and accuracy for predicting TFI, as determined by laparoscopy and dye hydrotubation, were calculated for each test alone, and in parallel and series combination. Results: Thirty per cent (63/207) were diagnosed with TFI. The highest sensitivity (67%, 95% CI: 54-77) included any positive test, yet missed one in three women with TFI. The highest specificity (100%, 95% CI: 97-100) required all three tests positive, but identified only three women. Only the combination of CAT and TVU rated as a good clinical test, but confidence intervals were wide due to the small numbers affected. The combination of CAT or TVU and CAT alone reported the highest accuracy (73%, 95% CI: 66-78), misdiagnosing one in four women. Conclusion: Medical history, TVU appearances, and ELISA IgG CAT alone, or in combination, failed to predict accurately TFI in subfertile women.

KW - Chlamydia trachomatis antibody test

KW - medical history

KW - subfertility

KW - transvaginal ultrasound

KW - tubal infertility

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KW - WORK-UP

KW - TRACHOMATIS

KW - HYSTEROSALPINGOGRAPHY

KW - LAPAROSCOPY

KW - DIAGNOSIS

KW - COMPLICATIONS

KW - METAANALYSIS

KW - PATHOLOGY

KW - ACCURACY

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DO - 10.1093/humrep/deg471

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VL - 18

SP - 2350

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JF - Human Reproduction

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