Chlamydia trachomatis detected by polymerase chain reaction in cervices of culture-negative women correlates with adverse in vitro fertilization outcome.

The prevalence of Chlamydia trachomatis in the endocervices of 307 asymptomatic culture-negative women undergoing in vitro fertilization (IVF) was evaluated. C. trachomatis was detected by polymerase chain reaction (PCR) in 20 subjects (6.5%), and there were strong correlations between a positive finding and both failure to become pregnant (P = .013) and spontaneous abortion after embryo transfer (P = .004). C. trachomatis was identified in 2 (1.8%) of 112 who had term deliveries, 3 (27.3%) of 11 who spontaneously aborted, 1 (3.3%) of 30 with biochemical pregnancies, 13 (9.6%) of 135 with no pregnancy after embryo transfer, and 1 (5.3%) of 19 whose embryos did not become fertilized. There were no relationships between PCR findings and maternal age, cause of infertility, number of oocytes retrieved or fertilized, or number of embryos transferred; 55% of PCR-positive and 40% of PCR-negative women were undergoing at least their second IVF. An undetected C. trachomatis infection may be responsible for implantation failure or spontaneous abortion after IVF and embryo transfer.