Guest
Duan Tao and Li Kunming
Interview Background
The Jing'an District Office of the Joint Conference on Public Health, the Jing'an District Center for Disease Control and Prevention, and the Jing'an Media Center have jointly launched the Promoting Medical Knowledge for Sustained Health interview series. This episode focuses on chlamydial infections of the reproductive tract. The host from the Jing'an Media Center will have a Q&A and interactive discussion with three experts to educate the public about the prevention and treatment of chlamydia infections and raise awareness about reproductive health.
Host:
Hello, everyone, and welcome to Promoting Medical Knowledge for Sustained Health. Today, we are honored to have two esteemed guests with us. One of them is Professor Duan Tao, a Senior Physician, professor, and doctoral supervisor who leads the Obstetrics Department at Shanghai First Maternity and Infant Hospital. Professor Duan is also the chief scientist of a key national research project. Welcome, Professor Duan.
Duan Tao:
Thanks for having me. Hello, everyone.
Host:
The other guest is Dr. Li Kunming, Deputy Director of the Assisted Reproductive Medicine Department at Shanghai First Maternity and Infant Hospital, Senior Physician, PhD Supervisor, and a member of the Reproductive Medicine Branch of the Chinese Medical Doctor Association. Welcome, Dr. Li.
Li Kunming:
Nice to meet you.
Host:
Today, we'll be discussing chlamydial infections of the reproductive tract. I'm not very familiar with this condition, so I'd like to ask both of you: what exactly is a chlamydial infection of the reproductive tract?
Duan Tao:
The reproductive system is a natural passage that connects to the outside world, making it susceptible to sexually transmitted diseases. For women, the most common reproductive tract infections aren't necessarily directly linked to sexual transmission. Chlamydia is one such infection. What sets it apart from other common infections is that a considerable number of cases show no typical symptoms, so it often goes unnoticed. As doctors, we routinely check for it when examining reproductive tract infections, but the general public may not be very aware of it in their daily lives.
Host:
Is there a risk of transmission in places like bathrooms or swimming pools?
Duan Tao:
There is a slight possibility of transmission through shared towels or personal hygiene items in public bathrooms, but the likelihood is quite low. The main route of transmission is still through sexual contact.
Host:
I see. You just said that it's often an asymptomatic infection, right?
Duan Tao:
We call it an asymptomatic infection because over half of the people show no symptoms. However, there are still quite a few who do have symptoms. It can affect the urogenital tract, leading to urinary tract infections. In cases of vaginal infection, it may impact the cervix endometrium, and could spread upwards to the fallopian tubes and even the pelvic cavity. In the infection process, it can manifest either with symptoms or without, but compared to other infections, the rate of asymptomatic cases is generally higher.
Host:
Which age group is more prone to this infection?
Duan Tao:
It is related to sexual activity. Among women, the 20 to 30 age group tends to be more sexually active, so the incidence rate is higher in this age group.
Host:
Let's take women as an example. If an infection occurs, what changes will happen in the body?
Li Kunming:
In the case of a chlamydia infection, more severe cases might present with symptoms. However, there's about a 50% chance that the infection will be silent, meaning no obvious symptoms will appear. For patients coming in with abnormal leukorrhea, we take this into account and suggest appropriate tests. For those seeking help with other issues, especially infertility, we recommend microbial screenings to determine whether a silent infection might be present. If chlamydia infection is the cause of infertility and it isn't treated in time, the infection may progress, and symptoms will appear later. It can damage the endometrium, cause inflammation of the fallopian tubes, and, in severe cases, lead to hydrosalpinx, posing a serious risk to fertility. Therefore, it's important to seek immediate screening and take the initiative to get tested.
Host:
Have you come across any particularly memorable cases among your patients that you could share with us?
Li Kunming:
I once went to a rural hospital to perform surgery on a patient who had developed a tubal abscess, accompanied by the inflammation Dr. Duan mentioned earlier. The patient had a fever, so we performed surgery to determine which microorganism caused the infection. We conducted relevant tests and ultimately discovered that it was a mixed bacterial infection, including chlamydia. This is a very typical case. Usually, when we see chlamydia infections, most are silent or cause very mild symptoms even if they're not fascial infections. This patient, due to poor hygiene conditions, developed a severe tubal abscess. Of course, chlamydia was one of the main culprits.
Duan Tao:
What Director Li mentioned was a rare but very notable case. In most situations, there aren't any specific symptoms, but when you perform pathogen tests, you'll find that it's a chlamydia infection.
Host:
I see. You mentioned earlier that early screening and treatment are important, correct? How often would you suggest people get tested or go through preventive screenings?
Li Kunming:
We advise women of childbearing age or those after starting sexual activity to have a check-up once a year. For specific groups, such as those experiencing infertility, when they come for infertility-related examinations, we generally consider three main causes of infertility, right? One is related to the fallopian tubes, another is sperm issues in the male, and the third is ovulation problems in the female. When they come for tests, most doctors typically focus on these three factors. If all three are normal, then chlamydia infections should be considered. About 10% of people are still unable to conceive, and this is known as unexplained infertility. Among those 10% of cases, some may be caused by pathogens like chlamydia, so we recommend relevant screenings.
Host:
I see what you mean. Many of us are curious about the specific dangers of chlamydia infections in the reproductive tract. The risks might vary among different groups. Could you share more about that?
Duan Tao:
Director Li works with patients who are dealing with infertility, so he spoke about the impact of chlamydia in that group. From an obstetric perspective, we also monitor for it during pregnancy checkups, as it can affect both the mother and the child. For example, if chlamydia is contracted during pregnancy, it can cause vaginal inflammation, which may lead to premature rupture of membranes or preterm birth. Furthermore, if the mother is infected during delivery and the baby is born through the birth canal, the baby has a higher risk of developing conditions like keratitis or conjunctivitis. What is the full name of chlamydia? It's chlamydia trachomatis. It was first identified in trachoma, an eye infection, and this pathogen was linked to the disease. Later, it was discovered that it not only causes eye issues but is more commonly found in the reproductive tract. In the reproductive tract, newborns exposed during birth have a noticeably higher risk of developing conjunctivitis. As obstetricians, we focus on the unique changes during pregnancy and the possible negative effects on both the mother and child.
Host:
I see. What kind of effects does it have on women of childbearing age?
Li Kunming:
Chlamydia doesn't affect ovulation in women because it mainly infects mucous membrane tissues. For women of childbearing age, it can cause changes in the epithelial tissues, leading to inflammation. But having a chlamydia infection doesn't mean it's a life-threatening condition or that you'll definitely be infertile. It's just that for some people, chlamydia can cause severe inflammation, such as affecting the cervical epithelium and leading to cervicitis. This makes it much harder for sperm, eggs, or embryos to move smoothly through the fallopian tubes. Also, the inflammation of the fallopian tubes can be a problem. If the inflammation is severe, the sperm and egg won't even get a chance to meet, and no embryo will form. Even if they do meet in the fallopian tube and form an embryo, implantation must occur in the endometrium. However, if the endometrium is inflamed, even a healthy embryo may fail to implant due to the damage caused by pathogenic microorganisms. It's like trying to plant crops in saline-alkali soil—nothing will grow. Therefore, it impacts the meeting of sperm and egg in various ways, interferes with embryo implantation, and eventually leads to infertility in some people.
Host:
As we approach the end of our show, could you offer some advice to our audience?
Duan Tao:
For women, maintaining and promoting reproductive tract health is crucial. The principles for preventing and treating chlamydia are consistent with those for other sexually transmitted diseases. First, it's important to be aware of it and take it seriously. Second, early screening, diagnosis, and intervention are crucial. Women have special windows of opportunity, such as premarital checkups, pre-pregnancy planning, and prenatal exams, where routine screenings can help detect it early and ensure timely intervention, reducing the risk of future complications.
Li Kunming:
For chlamydia infections, we need to take it seriously and actively treat them. If you do become infected, don't panic—just focus on addressing the issue. It's also essential to pay attention to your lifestyle and take steps to maintain reproductive health. Once an infection occurs, early treatment is crucial. After treatment, if you wish to conceive, you can begin preparing for pregnancy. A chlamydia infection doesn't mean you won't be able to get pregnant—just remove this hurdle, and you can still conceive successfully.
Host:
Got it. I'm sure after hearing from our two guests, everyone now has a thorough understanding of chlamydia infections in the reproductive tract. We also hope that everyone will actively engage with us in the live chat. Thank you again to our guests for being here. See you next time!