Trifactorial Influence—Antisperm Antibody, Anti-Chlamydia Antibodies, and Thyroid Levels in Infertility

Q4 Medicine
Sopia A Rajamanickam, Joseph Pi Danislas, K. Mohanram, Shanthi Dinakaran, A. J. Henry
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Abstract

Ab s t r Ac t Aim and objective: The present study determines the incidence of anti-Chlamydia antibodies (ACA), antisperm antibody (ASA), and thyroid levels in serum of infertility patients and statistically determines the significance of all three study parameters. Materials and methods: A cross-sectional study was conducted on volunteers of 190 patients both male and female reporting to the Infertility Clinic of hospital and 178 patients including pregnant women patients were used as control. Serum from patients was collected and analyzed for the presence of anti-Chlamydia antibodies, ASA, serum T3, T4, and thyroid-stimulating hormone (TSH) levels by enzyme-linked immunosorbent assay (ELISA). Results: Infertility patients representing 12.6% of the study population tested positive for anti-Chlamydia antibodies. 21.6% of 190 patients had high ASA levels and these levels were found to be statistically significant p < 0.001 when compared with control. Elevated thyroid levels of the study population observed as increased T3 in 26 patients and T4 in 18 patients with 16 patients having increased TSH and the increased levels of thyroid in infertility patients compared with control is statistically significant p value <0.01. Correlation between all three study parameters is statistically significant [0.01 level (two-tailed)]. Conclusion: Significantly higher levels of anti-Chlamydia antibodies and ASA are found associated in infertile patients as is elevated T3, T4, and TSH. All three parameters together can cause infertility showing the multidimensional factors for the development of infertility. Clinical significance: Patients with infertility should be screened for all three study parameters viz. ACA, ASA, and thyroid levels and subsequent treatment protocols to resolve all possible adverse results to within normal levels for the success of ART. Research highlights • The present study found higher levels of anti-Chlamydia antibody in patients with primary infertility compared with the control group indicating the strong association between chlamydial infections and infertility. • The present study found higher levels of antisperm antibodies in the serum of patients with primary infertility compared with the control group implying a significant role for ASA and development of infertility. • Thyroid disorders such as hypothyroidism due to elevated TSH and hyperthyroidism associated with increased total serum T3 or T4 are several times higher in infertility patients when compared with the general population providing evidence for thyroid imbalance and infertility. • All three study parameters—anti-Chlamydia antibodies, ASA, and thyroid levels occurring together in any one patient may tend to cause infertility.
不孕患者抗精子抗体、抗衣原体抗体和甲状腺水平的三因素影响
目的和目的:本研究确定了不孕患者血清中抗衣原体抗体(ACA)、抗精子抗体(ASA)和甲状腺水平的发生率,并从统计学上确定了所有三个研究参数的显著性。材料和方法:对190名男性和女性患者的志愿者进行横断面研究,并将178名患者(包括孕妇)作为对照。收集患者血清,并通过酶联免疫吸附试验(ELISA)分析是否存在抗衣原体抗体、ASA、血清T3、T4和促甲状腺激素(TSH)水平。结果:占研究人群12.6%的不孕患者的抗衣原体抗体检测呈阳性。190名患者中21.6%的患者ASA水平较高,与对照组相比,这些水平具有统计学意义,p<0.001。与对照组相比,研究人群甲状腺水平升高,26名患者T3升高,18名患者T4升高,其中16名患者TSH升高,不孕患者甲状腺水平升高具有统计学意义,p值<0.01。所有三个研究参数之间的相关性具有统计学意义[0.01水平(双尾)]。结论:不孕患者的抗衣原体抗体和ASA水平显著升高,T3、T4和TSH水平升高。这三个参数加在一起都会导致不孕,这表明了不孕发展的多方面因素。临床意义:不孕患者应筛查所有三个研究参数,即ACA、ASA和甲状腺水平,以及随后的治疗方案,以将所有可能的不良结果解决在正常水平内,从而使ART成功。研究重点•本研究发现,与对照组相比,原发性不孕患者的抗衣原体抗体水平更高,这表明衣原体感染与不孕之间存在密切联系。•本研究发现,与对照组相比,原发性不孕患者血清中的抗精子抗体水平更高,这意味着ASA和不孕的发展具有重要作用。•与提供甲状腺失衡和不孕证据的普通人群相比,不孕患者的甲状腺疾病,如TSH升高引起的甲状腺功能减退和与总血清T3或T4升高相关的甲状腺功能亢进,要高出数倍。•所有三个研究参数——抗衣原体抗体、ASA和甲状腺水平——在任何一名患者身上同时出现都可能导致不孕。
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CiteScore
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