In developing countries, data about the prevalence of genital Chlamydia trachomatis infections and their sequelae, especially tubal infertility, is scarce.A prospective case-control study was performed enrolling 239 Ghanaian women.The case group included 93 patients with primary or secondary infertility.The control group consisted of 146 healthy pregnant women.First-void urine samples were investigated by PCR, and serum specimens were tested for C.trachomatis-specific IgG antibody.Demographic and behavioral information were gathered for statistical analysis.The PCR prevalence of C.trachomatis was relatively low and did not differ significantly among both groups (2.5versus 1.7%).In contrast, significantly higher prevalences of specific IgG (40% versus 21%) antibody were found among infertile women.The adjusted odds ratios were 2.1 and 2.8, respectively.Our data suggest that previous C.trachomatis infections may contribute to infertility inChina women.