Abstract
Tubal pelvic damage is a common cause of infertility, and laparoscopy
is the accepted gold standard for its diagnosis. However, laparoscopy
is both costly and invasive. Chlamydia is now recognized as the
most common cause of tubal pelvic damage. In contrast to laparoscopy,
evidence of past chlamydial infection using serology is readily
avilable, and the test is simple and quick to perform. As such, serology
can be used as a screening test in infertile women. It is accepted that
screening tests may have higher margins of error and may be less
accurate than diagnostic tests. Screening is most valuable when
detecting a disease for which the treatment is more effective when
undertaken at the earliest opportunity. Because there are justified
constraints to the indiscriminate use of laparoscopy, there is a need to
minimize the number of patients who do not have disease (false
positives) who are subjected to this diagnostic investigation. An
appropriate Chlamydia antibody titre that would distinguish women
at risk of tubal pelvic damage should be determined using diagnostic
test analysis and clinical judgement. Identification by serology of
women who are likely to have damage would enable these women to undergo a
diagnostic test such as laparoscopy sooner, allowing treatment to be
provided earlier. However, the severity of tubal pelvic damage varies,
and the need to distinguish women with a favourable or unfavourable
prognosis after treatment using a simple classification system is
discussed.
Translated title of the contribution | Tubal Pelvic Damage: prediction and prognosis |
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Original language | English |
Pages (from-to) | S15-S20 |
Number of pages | 6 |
Journal | Human Fertility |
Volume | 5 |
Issue number | Supplement 1 |
Early online date | 3 Jul 2002 |
DOIs | |
Publication status | Published - 2002 |