Objective: The objective of our study was to evaluate possibilities of serum examination of inferti- le women, particularly as a screening test of tubal damage, and comparison of two diagnostic methods. Design: Retrospective study. Setting: The Department of Gynecology - Obstetrics of the General Teaching Hospital and the 1 st Medical Faculty of the Charles University in Prague. Methods: 528 women were included in the study, which were monitored at the 1 st Department of Gynecology - Obstetrics from September 1993 to June 1997. The total group was divided into infertile and fertile women (women before artifical termination of pregnancy and pregnant wo- men app. 4 week before delivery). The group of infertile patients was further divided into sub- groups, according to their diagnosis. For all women examined, two smears from cervix were taken for antigen detection using a direct immunofluorescence method (DIF - DFA, Chlamyset Orion), and using an immuno-enzymatic method (ELISA - Wellcozyme set, Murex). From a blood sample, a level of IgA and IgG anti-Chlamydia antibodies was ascertained. For 200 sero-positive or anti- gen-positive women, we performed tests of the serums preserved, using specific micro-immunoflu-orescence tests (MIF) (SeroFia, MRL, Labsystem Savyon). We determined prevalence of antigen, IgA and IgG antibodies in individual groups and subgroups of women. We compared both sero- diagnostic methods and determined prevalence of specific antibodies for individual species of Chlamydia in the groups and sub-groups. Results: A high prevalence of active Chlamydia infection (11%) was ascertained in the total group of women. Occurrence of IgG anti-Chlamydia antibodies was statistically significantly higher in the group of sterile patients, i.e. 63.5, compared to 49.5% in the group of fertile women. In the subgroup of infertile women with tubal infertility factor, IgG anti-Chlamydia antibodies were diagnosed in 92%, compared to 40% in case of groups with other causes of infertility. MIF method has a lower sensitivity then ELISA. For women with tubal infertility factor, 90% of MIF IgG positive serums are positive for Chlamydia trachomatis. Conclusion: Chlamydia trachomatis is the most frequent agent of tubal damage. Species-specific IgG antibodies would be a useful supplementary initial examination of infertile patients. In case of positive results, a suspicion of tubal damage is high.

        Key words: tubal infertility factor, Chlamydia trachomatis, anti-Chlamydia antibodies specif ic for