The clinical significance of the examination

According to the results of the most perfected methods of laboratory diagnoses, it appears that on a daily basis we live together with many infectious agents, which – traditionally – were consider as almost necessarily pathogens. It seems that our coexistence with Chlamydia, which is known to cause specific clinical problems under certain conditions, is closer and in fact people can be infected non–sexually by this microorganism, very easily.

Unfortunately, the degree of danger of Chlamydia has not been determined for each person at a specific stage of his life, nor has the degree of severity of the treatment that must be taken on a case–by–case basis been determined. However, we safely recommend to women the detection of the microorganism, before any kind of gynecological surgery or even before checking the permeability of the fallopian tubes.

Until recent years, there was no satisfactory diagnostic approach for the detection of these microorganisms mostly because of false negative results. Additional approaches that hinted at the presence of Chlamydia, such as PAP or some of the traditional, low–sensitivity tests, largely disoriented the population with false negative results. The method of studying the female genital system that we ourselves introduced in 2001 is the examination of the menstruation tissue for chlamydia DNA content. This is an examination with significant advantages, such as the content of tissue from the upper genital tract, the easy collection at home without a medical visit, the preservation of the material without any consequences and the exceptional sensitivity and specificity. The acceptance of the examination by the Greece population and abroad was very high. The test is widely used as a screening test of choice for both prevention purposes by young women and for infertility testing by couples in need. The method highlights the presence of Chlamydia (positive result) in a percentage of about 35% in woman with subfertility problems (publication Michou etol. 2012).

Antibiotics are of course required to treat Chlamydia. But please be careful! Do not assume that the goal, which in theory is the complete elimination of Chlamydia, can always be achieved. From our experience, there have been cases in which, in an effort to completely eliminate the infection, Chlamydia disappeared (according to this sensitive method) after 8 monthly cycles, that the gynecologist had chosen (probably wrongly) a continuous antibiotic treatment. The personal opinion of the writer is the one–time strict treatment, and the re–examination to be done with the same method after a period of 6 or 12 months. Cumulative antibiotic therapy for Chlamydia, a germ with “hidden” (intracellular) biology, is not advocated.

In addition, it is assessed that Chlamydia should be controlled in men as well with SPI Test, for fear of chronic epididymitis or the possibility of worsening of the sperm diagram. Here, the presence of Chlamydial infection must be co–estimated with the parameters of the sperm diagram, when calculating the need for antibiotic treatment. Also, the coexistence of other microbes in the sperm that could favour the approach of administration must be weighed. In general, the microbial agent should usually be treated first in an attempt to correct an oligo– or astheno– or teratospermia, especially when surgery (eg: varicocele correction) or testicular puncture is to be performed.

The menstruation tissue test (as in the HIDDEN–C TEST), in addition to detecting Chlamydia, can also be used to detect other microorganisms of clinical importance, such as Mycoplasma, Ureaplasma and Atopobium V etc . Real Time PCR in a menstruation blood sample offers exceptional sensitivity and specificity compared to conventional methods for detecting these microorganisms such as vaginal / cervical fluid cultures.

–Triple examination of Mycoplasma / Ureaplasma / Chlamydia:

• Μycoplasma hominis
• Ureaplasma urealyticum
• Chlamydia trachomatis

Apart from Chlamydia, the endometrium is also vulnerable to infections of microorganisms, such as Mycoplasma and Ureaplasma, while Ureaplasma in particular has been associated with spontaneous miscarriages. In addition, Mycoplasma and Ureaplasma originating from the prostate can adversely affect sperm characteristics, such as sperm concentration and motility, while Chlamydia infection can cause morphological abnormalities in sperm, such as those of the middle section. We believe that the presence of Mycoplasma and Ureaplasma should be investigated and if found to be treated with medication, in both spouses.

Tsilivakos Vasilis MD, PhD,
Immunologist and Pathologist
Reproductive Immunology Researcher

The collection of menstruation tissue in the special collection vial (provided free of charge by LOCUS–MEDICUS) for the examination of the hidden Chlamydia can be done very easily in your home and does not require a visit to a doctor. It takes place in the phase of the first large flow (usually in the morning of the second day of menstruation). Avoid adding urine to the sample. The menstruation flow is uncontrollable. It does not occur after muscle strain or tightening or urination.

1. Unscrew the cap. Do not empty the liquid contents.

2. Touch the mouth of the vial to the back end of the genital area – i.e. the vaginal entrance – (posterior frenulum) and with ascending movements slide the vial mouth forward in full application (touch) with the skin, and detach the menstruation drop that naturally comes out.

If the material is mucous it often does not flow to the bottom of the tube but remains close to the mouth. In this case, screw the cap on and invert the tube so that the liquid contents drag the menstruation material to the bottom of the tube after a second inversion (return the tube to an upright position).

3. You do not need a large amount of material, as long as the contents of the liquid are well reddened. Solid pieces (coagula) etc, often contained in menstruation tissue, do not pose any problem.

The whole operation can be repeated until the collection of the required quantity.

4. After collecting the material, screw the cap well, wash the outside of the tube thoroughly with soap, stick the label with your name on the tube, wrap it in foil and store it in the refrigerator, until it is ready for examination. Your doctor will determine which microorganisms will be tested with a molecular test.

Please do not hesitate to contact us for any questions you may have.