Chlamydial Antibodies , Pro-Inflammatory Cytokines and Bacterial Significance among Infertile Women

Abd-Alnabi Jouiad Abid,Afrah Jawad Al-Zwaid
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Keywords : IL-10, female infertility, bacterial isolates, Chlamydia trachomatis.
Medical Journal of Babylon  12:4 , 2016 doi:1812-156X-12-4
Published :17 January 2016


The current study was done to investigate the relation between the bacteria different kindsandinfertility in women, the study include 108 specimen from infertile and fertilewomen with ages range (20-40years) these specimens collected from infertility and gynecology center of Maternity and Pediatrics Teaching Hospital in Babylon province. Urine, vaginal swabs and blood samples were used in this study. Bacteriological diagnosis for urine and vaginal swabs accomplished and showed variation in types and number of isolates.The isolates can be distributed as follows:Gram positive bacterial isolates include Staphylococcus aureus 48 (30%) 18 isolates urine and 30vaginal swabs, Escherichia coli24urine and 19 vaginal swabs43(26.8%). Female infertility divided according to their causesinto different types and the detection by anti-Chlamydia trachomatis antibodies reveals high concentration of IgG (46%) in the women with Polycystic ovary syndrome group,while the second high concentration (36%) in women with primary infertility . Immunological test of Cytokine IL-10 in patient show decreased in their concentration 11.5pg/ml compared with healthy at P< 0.05 especially at polycystic ovary syndrome group.


Infertility is the inability to conceive after one year of regular unprotected sexual intercourse. The infertility of any given couple is not absolute and it takes a healthy couple, on average, a year to achieve pregnancy given normal anatomy, physiological and sexual function. It affect about 10-15% of couples [1]. The causes are divided into several etiologies including genetic, physical abnormalities , tubal factor, ovulatory dysfunction, diminished ovarian reserve,sexualtransmitted diseases(STD), polycystic ovary syndrome, endometriosis and uterine factor [2]. In general, Chlamydia trachomatis is a main reason of sexual transmitted bacterial infections (STI), over 85 million individuals are affect every year by this bacteria [3] and the figures refers to increasing through the past 10 years in the USA and Europe [4].Infection can ascend to the upper tract and cause endometritis, salpingitis and pelvic inflammatory disease (PID) that is difficult to define and diagnose [5], potentially leading to tubal pathology and infertility later, [6]. In the long term, C. trachomatis reduces fertility in women the presence of Chlamydia IgG antibodies in serum is associated with tubal pathology and lower natural conception rates, even in matter of tubal patency [7]. IL-10 cytokine characterize by its immunosuppressive effect, it has a nature of dual-side in infectious diseases [8]. One side, the excessive produce of IL-10 has a link with the immune response of the host and how far the bacteria or viruses show resistance, the second side, IL-10 has an essential part in the preventing of immunopathology that may sequel from immoderate response of the inflammation [9].IL-10 has been shown to minimize the harmful and devastating effect of C. trachomatis on human Fallopian tube [10].The current study aimed to detect the association of bacteria and chlamydial infection in infertile women.

Materials and methods

Five ml of blood were withdrawn from each patients and control placed in plain tube, let in room temperature for 30 minutes for coagulation, centrifuged at 3000 rpm for serum separation.The collected sera were stored at -20 ?C until used in immunological investigations including Elisa assay for detection of IL-10 concentration in patients sera according to company(Elabscience) instructions. Searching for Chlamydiatrachomatis were carried out depending on serological detection of anti-ChlamydiaIgG in sera of infertile women according to company(Novalisa) instructions. Transport sterile cotton swabs and different cultural media were used for cultivation and isolation of bacteria [11]. The bacterial isolation and identification was performed according to the recommended diagnostic procedures and the final identification was achieved biochemically by using different biochemical reagents [12].


Bacteriological investigations for urine and vaginal swabs obtained from infertile patients show variation in number of bacterial isolates with different causes of infertility, Staphylococcus aureus reveals high percentage of isolates, followed by Escherichia coli of the total isolates, as showed in (Table 1).Serological test reveals positive cases for anti-Chlamydia IgG in different groups; the most one appeared with those infected with polycystic ovary syndrome at P<0.05 as mention in (Table 2).


The present investigation was highlight the accompanying bacterial infections for infertile women, which included a total number of 108 clinical samples (urine and vaginal swap) that subjected to bacteriological, morphological, and biochemical characterization indicated the high percentage of culture belong to Gram positive bacteria with eighty bacterial type compared with gram negative bacteria and this might be according to the fact that grams positive bacteria are commensals of mucosal surfaces of genital tract and that were resembled to those results being reported by previous research [13].Besides this, Staphylococcus aureus occupied the most percentage within the total isolates from infertile women this may related with infertility by their role with post-inflammatory alteration after infection in individuals and in case of non- treatment or resistant bacteria develop and the infection impact on the female reproductive organs which may leading to consequences linked with female infertility, this was in line with reports from other studies that shown S. aureus the dominant organism implicated in primary infertility [14]. The present study also agreed with the result mentioned bya researcher and his mate [15], and was close to the finding by researchers [16]. According to existing study the data revealed that infected women with previous Chlamydia trachomatis infection were just sited in the two fields primary infertility and polycystic ovary syndrome with percentage (36%, 46%) respectively,Many previous studies showed that Chlamydia trachomatis infections correlated with female infertility as the most causes of sexual transmitted diseases (STD) and ChlamydialIgG antibodies can persist at stable levels for years after infection [17], while many studies have shown that IgG antibodies of past C. trachomatis infection are correlated with infertility [18], [19]. The consequences were derived to damage the reproductive organs and may lead to hormonal disorder which derived to diseases such as polycystic ovary syndrome (PCOS), tubal factor infertility (TFI) and pelvic inflammatory disease (PID) such as[8]. The present study also showed decreasing in the serum levels of IL-10 in all patient groups who sustaining from female infertility compared with healthy group, the existent data was in line with the report from previous study by content that the decrease in Th2 cytokine IL-10 production compared with the increase Th1cytokines production such as TNF-? is connected to infertility [20]. Other study agreement with the sitting data their finding showed a decrease in the levels of IL10 may alter the tolerance to sperm cells in the female genital tract and reduce the favorable state for conception [21].


According to current study the most common bacteria accompany with infertile women Staphylococcus aureus, patients with female infertility appeared decreasing in the levels of IL-10 production and the serological test revealed presence of anti-chlamydia trachomatis IgG in certain patients from different causes of infertility and the high percentage in patients with polycystic ovary syndrome (PCOS).


1. AL-Shemmary B D. (2009) PhysioGynecological study of the effects of Metformin, Dian, and Androcur in treatment of infertile women with polycystic ovary syndrome in Babylon province, MSc thesis, College of medicine.University of Babylon.
2. QinqinMeng, A.B.; Aiguo Ren, B.; Le Zhang, B.; Jufen Liu, B.; Zhiwen Li, B.; Yan Yang C.; Rong Li, C.; Le M, L. (2015). Incidence of infertility and risk factors of impaired fecundity among newly married couples in a Chinese population. Reproductive BioMedicine 30, 92–100.
3. Starnbach M.N., Roan N.R. (2008) Conquering sexually transmitted diseases. Nat Rev Immunol 8(4): 313-7.
4. Bébéar C, de Barbeyrac B, (2009) Genital Chlamydia trachomatis infections. ClinMicrobiol Infect 15(1): 4-10.
5. French C. E., Hughes G., Nicholson A. Estimation of the rate of pelvic inflammatory disease diagnoses: trends in England, 2000–2008, Sexually Transmitted Diseases. 2011; 38 (3) 158–162.
6. Paavonen J. Eggert-Kruse W. (1999) Chlamydia trachomatis: impact on human reproduction. Hum Reprod Update 5(5): 433-447.
7. Coppus S. F., Land G. A., Opmeer B. C.Chlamydia trachomatis IgG seropositivity is associated with lower natural conception rates in ovulatory sub-fertile women without visible tubal pathology, Human Reproduction. 2011; 26 (11): 3061– 3067.

8. ?hman H., (2012) Immunogenetic risk factors of Chlamydia-induced tubal factor infertility. PhD. National Institute for Health and Welfare, Oulu, Finland.
9. Mege JL, Meghari S, Honstettre A, Capo C &Raoult D (2006). The two faces of interleukin 10 in human infectious diseases. Lancet Infect Dis 6(9): 557-69.
10. Hvid M, Baczynska A, Deleuran B, Fedder J, Knudsen HJ, Christiansen G &Birkelund S (2007) Interleukin-1 is the initiator of Fallopian tube destruction during Chlamydia trachomatis infection. Cell Microbiol 9(12): 2795-803.
11. Baron E.J, L.R. Peterson and S.M. Finegold. (1996). Bailey and Scott s Diagn. Microbial.9th ed, C.V. Mosby Company.
12. MacFaddin, J.F. 2000. Biochemical test for identification of medical bacteria. 3rd ed. Williams and Wilkins- Baltimor.USA.
13. Chimura T. and Saito H., A clinical study of asymptomatic bacteriospermia, Jpn. J. Antibiot., 43(1), 139-146 (1990).
14. Momoh, B. O. Idonije, E. O. Nwoke et al., “Pathogenic bacteria-a probable cause of primary infertility among couples in Ekpoma,” Journal ofMicrobiology and Biotechnology Research, vol. 1, pp. 66–71, 2011.
15. Onemu, S.O., Ibeh, N. (2001). Studies on the significance of positive bacterial semen cultures in male infertility in Nigeria. Int Fertile Women Med. 46:210-214.
16. Eiichi A., Monden K., Mitsuhata R., Kariyama R. and Kumon H., Biofilm formation among methicillin resistant staphylococcus aureus isolates from patients with urinary tract infection, Acta. Medica. Okayama., 58(4), 207-214 (2004).
17. Puolakkainen M, Vesterinen E, Purola E, Saikku P &Paavonen J (1986) Persistence of chlamydial antibodies after pelvic inflammatory disease. J ClinMicrobiol 23(5): 924-8.
18. Robertson JN, Ward ME, Conway D, Caul EO (1987) Chlamydial and gonococcal antibodies in sera of infertile women with tubal obstruction. JClinPathol 40(4): 377 83.
19. Toye B, Laferriere C, Claman P, Jessamine P & Peeling R (1993) Association between antibody to the chlamydial heat shock protein and tubal infertility. J Infect Dis 168(5): 1236-40.
20. Reid JG, Simpson NA, Walker RG, Economidou O, Shillito J, Gooi HC, Duffy SR, Walker JJ. The carriage of pro-inflammatory cytokine gene polymorphisms in recurrent pregnancy loss. Am J ReprodImmunol 2001; 45:35–40 .
21. Camejo MI. Relation between immunosuppressive PGE(2) and IL-10 to pro-inflammatory IL-6 in seminal plasma of infertile and fertile men. Arch Androl 2003; 49(2):111-116.

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