Scientists explain link between chlamydia and ectopic pregnancy.

Women who have had chlamydia are at greater risk of an ectopic pregnancy because of a lasting effect of the infection.

A new study provides evidence for the first time of how chlamydia can increase the risk of an ectopic pregnancy – which occurs when an embryo implants outside the womb, in the Fallopian tube.

Researchers at the University of Edinburgh found that women who had had the sexually transmitted infection were more likely to produce a particular protein in their Fallopian tubes. Increased production of this protein – known as PROKR2 – makes a pregnancy more likely to implant in the Fallopian tube.

The study follows on from research, also at the University of Edinburgh, which showed that production of a similar protein increased the likelihood of smokers having an ectopic pregnancy.

Chlamydia is the most common sexually transmitted infection in the UK. It can be treated but often goes undiagnosed because it can occur without symptoms. The infection is known to cause infertility as it can lead to scarring and blockages in the Fallopian tube.

This research shows, however, that chlamydial infection linked to ectopic pregnancy causes much more subtle changes in the Fallopian tube, without evidence of severe scarring. The study, published in the American Journal of Pathology, was funded by the Wellbeing of Women and the Medical Research Council.

Dr Andrew Horne, of the University of Edinburgh's Centre for Reproductive Biology, said: "We know that chlamydia is a major risk factor for ectopic pregnancy but until now we were unsure how the infection led to implantation of a pregnancy in the Fallopian tube. We hope that this new information allows health care providers to give women accurate information about risks following chlamydial infection and to support public health messages about the importance of safer sex and chlamydia testing."

YOUNG Australians will be paid $10 to get tested for chlamydia, as health experts look for new ways to combat rising rates of the sexually-transmitted infection.

Young people aged 16 to 30 who are sexually active will be paid $10 if they accept an offer at a participating pharmacy to undergo a chlamydia test. The initiative is a pilot program running solely in the ACT but if it proves a success, Associate Professor Rhian Parker said it could be rolled out nationally. Another $10 is given to the pharmacy for each test they perform, and Dr Parker said if it curtailed transmission of the infection then it would be money well spent.

"Absolutely ... chlamydia has a significant cost to the community," said Dr Parker from the Australian Primary Health Care Research Institute at the Australian National University.

"Treating infertility when women are in their 30s, for example, is a very expensive process.

"What we are trying to do is raise awareness, provide access to young people to testing but also to show that chlamydia is something that anyone can get that is sexually active."

A chlamydia infection is usually easy to resolve with antibiotics but because it has no symptoms it can go unnoticed, and so untreated, for years.The longer-term effect can be devastating, Dr Parker said, with two-thirds tubal infertility and a third of all cases of ectopic pregnancy attributed to the infection. She said chlamydia transmission rates had "risen significantly" in the ACT over the past decade, as part of a trend seen across the country. The pilot study is aiming to test 300 to 400 young people, meaning a total outlay of $6000 to $8000 in payment to those tested and also the pharmacies.

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