Abstract
Chlamydia trachomatis is the most common sexually transmitted bacterial infection in the United States.
Within the U.S. military, the age- and race-adjusted chlamydia infection rates among
female service members are consistently higher than civilian rates, with a 20% annual
acquisition rate among young active-duty women. The sequelae of chlamydia disproportionately
impact women in terms of severity and cost. Untreated chlamydia progresses to pelvic
inflammatory disease in 40% of cases, and is a leading cause of fallopian tube damage
and pelvic adhesive disease resulting in ectopic pregnancy, tubal infertility, and
acute and chronic pelvic pain. Tubal infertility is among the leading indications
for in vitro fertilization (IVF) nationally and rates among couples undergoing IVF at military
treatment centers are double the national average. Collectively, chlamydia infection
represents a significant resource burden to the military health care system and, in
view of the serious gynecologic health sequelae, a significant threat to the readiness
of servicewomen. In this review, we discuss the gynecologic impact of chlamydia infection
within the military, the critical gaps for research funding, and opportunities for
intervention.
Keywords
chlamydia - salpingitis - tubal - infertility - ectopic - military
