Does addition of anti-inflammatory agents to antimicrobial therapy reduce infertility after murine chlamydial salpingitis?

BACKGROUND AND OBJECTIVES Infertility after murine chlamydial salpingitis can be prevented by tetracycline treatment given before or at the time of infection. This study evaluates the efficacy and timing of tetracycline treatment and anti-inflammatory agents in the prevention of inflammation and subsequent infertility. STUDY DESIGN The left ovarian bursae and uterine horns were inoculated with the mouse pneumonitis strain of Chlamydia trachomatis. Mice were mated 54 days after inoculation. RESULTS Infected mice treated with tetracycline beginning 2 days after infection showed mild inflammation and no significant reduction in fertility. However, when tetracycline treatment was delayed until 5 days after infection, a moderate degree of inflammation and a significant reduction in fertility (P < 0.01) was noted. Treatment with ibuprofen, prostaglandin E1 (PGE-1), or hydrocortisone beginning day 2 post-inoculation did not significantly alter the degree of inflammation or subsequent fertility. Mean anti-chlamydial IgG titers were significantly lower in mice treated with either PGE1 or hydrocortisone compared with infected, untreated mice. CONCLUSION These results indicate that while early treatment of chlamydial salpingitis may prevent infertility, delay in treatment may result in significant inflammatory damage and infertility. There was no apparent benefit from the addition of anti-inflammatory agents.