oa Molecular Diagnosis and Vaccines - Association between bacterial contamination of the uterine cervix at embryo transfer and success rate in in-vitro fertilization/intracytoplasmic sperm injection
In the last two decades, in-vitro fertilization and embryo transfer (IVF-ET) have been successful in the alleviation of long-standing infertility due to female or male factors. It is well documented that the results of IVF in the presence of male factor are not as good as those in patients with normal semen parameters. Intracytoplasmic sperm injection (ICSI) is now one of the most successful and viable techniques in assisted fertilization. It leads to an increase in the fertilization rates but without corresponding increase in implantation rates. Therefore, efforts were directed to create a perfect relationship between good quality embryos and receptive endometrium. The aim of this study was to evaluate the effect of Chlamydia trachomatis infection and microbial flora of the cervix at the time of embryo transfer on fertilization and implantation in women undergoing ICSI procedure. From June 2003 to November 2003, thirty participants with a male cause of infertility were enrolled in the study in Ain Shams University Maternity hospital. All were recruited from the outpatient clinic of Assisted Reproduction unit. After embryo transfer (ET), cervical scrapings were taken and tested for Chlamydia trachomatis DNA by PCR technique. Also the distal tip of the embryo transfer catheter was cut off and tested for bacterial growth by conventional culture techniques. Pregnancy tests were done 2 weeks later, and participants were accordingly divided into pregnant and nonpregnant groups. Chlamydia was detected in 30% of the non-pregnant group versus 10% of the pregnant one but with no statistical significance. Non significant difference was found between both groups regarding cervical bacterial growth. E. coli had border line significance in the non pregnant group. In conclusion, the present study supports the hypothesis that microbial flora of the cervix detected during ET have no role in the implantation process, and does not affect pregnancy rates in women undergoing ICSI procedure for infertility. However further larger scale studies are recommended to assess the possible role of Chlamydia trachomatis and E. coli.
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