Chlamydia antibodies and self-reported symptoms of oligo-amenorrhea and hirsutism: A new etiologic factor in polycystic ovary syndrome?

Objective: To investigate whether the systemic inflammation induced by chlamydial infections might be associated with symptoms of polycystic ovary syndrome (PCOS). Design: Nested case-control study. Setting: A questionnaire including questions about hirsutism and oligo-amenorrhea was distributed to a representative sample of women (at age 31) from the general population-based Northern Finland Birth Cohort. Those who reported both symptoms were defined as symptomatic (n = 81). Patient(s): A representative sample of women (at age 31) from the general population-based Northern Finland Birth Cohort. Intervention(s): None. Main Outcome Measure(s): To test the presence of serum antibodies to Chlamydia pneumoniae (IgG titers >= 32) and Chlamydia trachomatis (IgG titers >= 8) by microimmunofluorescence in symptomatic and control women. Result(s): Antibodies were investigated in 79 symptomatic and 1427 control women (C. pneumoniae) and in 79 symptomatic and 425 control women (C trachomatis). C. trachomatis antibodies (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.3-4.6) and C. pneumoniae antibodies (OR, 1.5; 95% CI, 1.0-2.4) were more commonly present in symptomatic women, and the simultaneous presence of elevated highly sensitive C-reactive protein levels strengthened this association. Conclusion(s): Chronic inflammation, which is associated with chlamydial infections, could contribute to the pathogenetic processes that lead to the metabolic and hormonal disorders of PCOS. (Fertil Steril (R) 2010;94:1799-804. (C)2010 by American Society for Reproductive Medicine.)