日本性感染症学会誌 Journal of Japanese Society for Sexually Transmitted Infections

Genital Chlamydia trachomatis infection is a major cause of tubal infertility. For cases of tubal occlusion, selective hydrotubation under hysterofiberscopy and laparoscopic surgery are generally performed. In this study, we examined the rate of tubal recanalization and pregnancy outcomes after treatment for tubal occlusion, and the presence or absence of C. trachomatis antibodies. We studied 347 patients who underwent hysterosalpingography between January 2013 and December 2018. The tubal occlusion rates were 30.2% in the antibody-positive group and 15.0% in the antibody-negative group; the rate was significantly higher in the antibody-positive group (p=0.010). The proportions of cases in which tubal recanalization was recognized by any of the tubal treatments were 90.0% in the antibody-positive group and 81.5% in the antibody-negative group, but no significant difference was found. After recanalization by either treatment, the pregnancy rates by natural pregnancy or intrauterine insemination were 33.3% in the antibody-positive group and 31.8% in the antibody-negative group; however, the difference was not statistically significant. We suggest that there is significance in performing tubal treatment by selective hydrotubation under hysterofiberscopy or laparoscopic surgery, not only for C. trachomatis antibody-negative cases, but also for antibody-positive cases.