Chlamydia trachomatis infection and complications reproductives in women: a systematic review




Pelvic inflammatory disease; Chlamydia trachomatis; Infertility; Women; Genital tract.


Chlamydia trachomatis is the most common sexually transmitted bacterium in the world. It is an obligate intracellular pathogen, with serotypes D and K1 responsible for infections in the genital tract. C. trachomatis mainly affects young adults and is defined as behavior younger than 25 years. The infection is asymptomatic in about 77% of women and 68% of men, which makes early diagnosis and treatment difficult. When undiagnosed and untreated, trachomatis can ignite the lower genital tract and reach the uterus, fallopian tubes and ovaries, resulting in pelvic inflammatory disease (PID). PID is associated with tubal factor infertility, ectopic pregnancy, intrauterine fetal death, miscarriage, and stillbirth. The objective of this work was to verify the scientific investigations related to the association between trachoma infection, female infertility and consequences on women's health. This is a descriptive, qualitative, bibliographic review study. For research, PubMed/Med platforms were used and articles published in the last ten years were published The review was performed according to the PRISMA recommendation (Key Items for Reporting Systematic Reviews and Meta-analysis) and using the Joana Briggs Institute Appraisal Tools (JBI) tool to eliminate the risk of bias. The following keywords were used “Chlamydia trachomatis”, “infertility” and “female”. The studies presented emphasize the impact of C. trachomatis on the female genital tract and the need for safe and rapid medical interventions.


Andersen, B., van Valkengoed, I., Sokolowski, I., Møller, J. K., Østergaard, L., & Olesen, F. (2011). Impact of intensified testing for urogenital Chlamydia trachomatis infections: a randomised study with 9-year follow-up. Sexually transmitted infections, 87(2), 156-161.

Azevedo, M. J. N. D., Nunes, S. D. S., Oliveira, F. G. D., & Rocha, D. A. P. (2019). High prevalence of Chlamydia trachomatis in pregnant women attended at Primary Health Care services in Amazon, Brazil. Revista do Instituto de Medicina Tropical de São Paulo, 61.

Brasil. (2013). Microbiologia clínica para o controle de infecção relacionada à assistência à saúde. Módulo 4: Procedimentos Laboratoriais: da Requisição do Exame à Análise Microbiológica e Laudo Final. Agência Nacional de Vigilância Sanitária. Brasília: Anvisa, 2013. 95p.: il.9 volumes.

Budrys, N. M., Gong, S., Rodgers, A. K., Wang, J., Louden, C., Shain, R., & Zhong, G. (2012). Chlamydia trachomatis antigens recognized by women with tubal factor infertility, normal fertility, and acute Infection. Obstetrics and gynecology, 119(5), 1009.

Den Heijer, C. D., Hoebe, C. J., Driessen, J. H., Wolffs, P., Van Den Broek, I. V., Hoenderboom, B. M., & Dukers-Muijrers, N. H. (2019). Chlamydia trachomatis and the risk of pelvic inflammatory disease, ectopic pregnancy, and female infertility: a retrospective cohort study among primary care patients. Clinical Infectious Diseases, 69(9), 1517-1525.

Elwell, C., Mirrashidi, K., & Engel, J. (2016). Chlamydia cell biology and pathogenesis. Nature Reviews Microbiology, 14(6), 385-400.

Galvão, T. F., Pansani, T. D. S. A., & Harrad, D. (2015). Principais itens para relatar Revisões sistemáticas e Meta-análises: A recomendação PRISMA. Epidemiologia e serviços de saúde, 24, 335-342.

Hoffman, B. L., Schorge, J. O., Halvorson, L. M., Bradshaw, K. D., & Cunningham, F. G. (2014). Ginecologia de Williams. Artmed Editora.

Haggerty, C. L., Gottlieb, S. L., Taylor, B. D., Low, N., Xu, F., & Ness, R. B. (2010). Risk of sequelae after Chlamydia trachomatis genital infection in women. The Journal of infectious diseases, 201(Supplement_2), S134-S155.

Huai, P., Li, F., Li, Z., Sun, L., Fu, X. A., Pan, Q., ... & Zhang, F. (2018). Prevalence, risk factors, and medical costs of Chlamydia trachomatis infections in Shandong Province, China: a population-based, cross-sectional study. BMC infectious diseases, 18(1), 1-11.

Huai, P., Li, F., Chu, T., Liu, D., Liu, J., & Zhang, F. (2020). Prevalence of genital Chlamydia trachomatis infection in the general population: a meta-analysis. BMC infectious diseases, 20(1), 1-8.

Janssen, K. J., Dirks, J. A., Dukers-Muijrers, N. H., Hoebe, C. J., & Wolffs, P. F. (2018). Review of Chlamydia trachomatis viability methods: assessing the clinical diagnostic impact of NAAT positive results. Expert Review of Molecular Diagnostics, 18(8), 739-747.

Kiguen, A. X., Marramá, M., Ruiz, S., Estofan, P., Venezuela, R. F., Mosmann, J. P., & Cuffini, C. G. (2019). Prevalence, risk factors and molecular characterization of chlamydia trachomatis in pregnant women from Cordoba, Argentina: a prospective study. PLoS One, 14(5), e0217245.

Newman, L., Rowley, J., Vander Hoorn, S., Wijesooriya, N. S., Unemo, M., Low, N., & Temmerman, M. (2015). Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. PloS one, 10(12), e0143304.

Nonato, D. R., Alves, R. R., Ribeiro, A. A., Saddi, V. A., Segati, K. D., Almeida, K. P., ... & Rabelo-Santos, S. H. (2016). Prevalence and factors associated with coinfection of human papillomavirus and Chlamydia trachomatis in adolescents and young women. American journal of obstetrics and gynecology, 215(6), 753-e1.

Pinto, V. M., Szwarcwald, C. L., Baroni, C., Stringari, L. L., Inocêncio, L. A., & Miranda, A. E. (2011). Chlamydia trachomatis prevalence and risk behaviors in parturient women aged 15 to 24 in Brazil. Sexually transmitted diseases, 957-961.

Porritt, K., Gomersall, J., & Lockwood, C. (2014). JBI's systematic reviews: study selection and critical appraisal. AJN The American Journal of Nursing, 114(6), 47-52.

Price, M. J., Ades, A. E., Soldan, K., Welton, N. J., Macleod, J., Simms, I., & Horner, P. J. (2016). The natural history of Chlamydia trachomatis infection in women: a multi-parameter evidence synthesis. Health technology assessment (Winchester, England), 20(22), 1-250.

Valladão, A. S., Costa, C. M. D. S. P., de Camargo, J. A., & Soares, V. C. G. (2011). Chlamydia trachomatis e suas implicações na reprodução humana. Revista do Instituto Adolfo Lutz, 70(4), 457-462.

Rowley, J., Vander Hoorn, S., Korenromp, E., Low, N., Unemo, M., Abu-Raddad, L. J., ... & Taylor, M. M. (2019). Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bulletin of the World Health Organization, 97(8), 548.

Seadi, C. F., Oravec, R., Poser, B. V., Cantarelli, V. V., & Rossetti, M. L. (2002). Diagnóstico laboratorial da infecção pela Chlamydia trachomatis: vantagens e desvantagens das técnicas. Jornal Brasileiro de Patologia e Medicina Laboratorial, 38(2), 125-133.

Sharaf M. A., El-Bohoty S. B., Hodeib H. A., & El-Kholi D. G. (2021). Chlamydia Trachomatis Infection as a Risk Factor of Infertility in Women. Journal of Advances in Medicine and Medical Research, 33(9), 63-70.

Steiner, A. Z., Diamond, M. P., Legro, R. S., Schlaff, W. D., Barnhart, K. T., Casson, P. R., & Network, R. M. (2015). Chlamydia trachomatis immunoglobulin G3 seropositivity is a predictor of reproductive outcomes in infertile women with patent fallopian tubes. Fertility and sterility, 104(6), 1522-1526.

Tamarelle, J., Thiebaut, A., Sabin, B., Bébéar, C., Judlin, P., Fauconnier, A., & Delarocque-Astagneau, E. (2017). Early screening for Chlamydia trachomatis in young women for primary prevention of pelvic inflammatory disease (i-Predict): study protocol for a randomised controlled trial. Trials, 18(1), 1-11.

Tang, W., Mao, J., Li, K. T., Walker, J. S., Chou, R., Fu, R., ... & Tucker, J. D. (2020). Pregnancy and fertility-related adverse outcomes associated with Chlamydia trachomatis infection: a global systematic review and meta-analysis. Sexually transmitted infections, 96(5), 322-329.

Tao, X., Ge, S. Q., Chen, L., Cai, L. S., Hwang, M. F., & Wang, C. L. (2018). Relationships between female infertility and female genital infections and pelvic inflammatory disease: a population-based nested controlled study. Clinics, 73.

Witkin, S. S., Minis, E., Athanasiou, A., Leizer, J., & Linhares, I. M. (2017). Chlamydia trachomatis: the persistent pathogen. Clinical and Vaccine Immunology, 24(10), e00203-17.



How to Cite

SALDANHA, R. de C. O. .; NATÁRIO, J. A. A. .; BARROS, L. A. S. .; MILKI, M. V.; RIBEIRO, A. A. . Chlamydia trachomatis infection and complications reproductives in women: a systematic review. Research, Society and Development, [S. l.], v. 11, n. 9, p. e19011931631, 2022. DOI: 10.33448/rsd-v11i9.31631. Disponível em: Acesso em: 5 oct. 2022.



Health Sciences