Iris Publishers_World Journal of Gynecology & Womens Health

Assessment of Bacterial Contamination at the Time of Embryo Transfer, and its Impression on the in-vitro Fertilization / Pregnancy Outcome, in Sana’a City, Yemen

Abstract

Background: In spite of advances in the field of assisted reproductive techniques including in-vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI), the pregnancy rate remained low. One of the major events in fertility is implantation process. One of the most important negative factors affecting implantation and pregnancy outcome is introduction of normal flora or potential pathogens of vagina or cervical region into uterus during embryo transfer.
Objectives: This study was designed to determine the most contaminants bacteria and examine the effect of bacterial contamination on in-vitro fertilization treatment outcomes.
Methods: A prospective clinical trial was carried out during a period of 12 months, starting in October 2016 and ending in September 2017. 162 patients aged 23–38 years, mean 32.4±5.7, undergoing IVF treatment were selected for this study. Catheter tip samples were collected poster embryo transfer, cut off and cultured to identify any bacteria present by bacterial standard methods.
Results: The pregnancy rate of the 162 studied women was 54.32% (positive B-hcg) and 45.68% had pregnancy failure (negative B-hcg). The highest positive pregnancy rate occurred in age group 26-29 years (63%). The most contaminants bacteria were Staphylococcus coagulase negative (21.4%), Non-hemolytic streptococci (17.9%), Pseudomonas aeruginosa (17.9%) and E. coli (14.3%). The pregnancy rates did not differ significantly between the positive and negative bacterial growth, but significant decreased pregnancy rate was observed in patients who are positive to Pseudomonas aeruginosa, and E. coli.
Conclusion: Bacterial colonization of the ET catheter tip particularly with Pseudomonas aeruginosa and E. coli is associated with a reduction in the clinical pregnancy rate. Usefulness of routine cervical swab; microscopy, culture, and sensitivity at preparation of patients for IVF–ET treatment is suggested.

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