Chlamydial IgG and IgA in serum and follicular fluid among patients undergoing in vitro fertilisation

Associations between microbial presence in follicular fluid with IVF outcomes: a systematic review and meta-analysis

PURPOSE

The aim of the study was to synthesize disparate studies to investigate potential impact of microbial presence in FF of infertile women on IVF outcomes.

METHODS

Following preliminary searches to find medical subject heading (MeSH) terms plus free terms, a systematic search was performed in the PubMed, Cochrane Library, Embase, Web of Science, and Clinicaltrials.gov databases from January 10, 2022, to July 5, 2023. Data collected for each study were analyzed using RevMan 5.4 software available on the Cochrane website.

RESULTS

After correcting for contamination from the vagina, the FFs of 289 women were detected positively by microbial culture and identification, ELISA, and IPA. The pregnancy rate of the FF-positive group was significantly lower than the FF-negative group (19.7% vs. 32.2%) and (OR: 0.57, 95% CI: 0.28-1.14, P=0.11; I2=56%) while the fertilization rate was almost equal (60.0% vs. 62.0%) and (OR: 1.03, 95% CI: 0.88-1.20, P=0.72; I2=0%). Evidence quality was very low.

CONCLUSIONS

The different species of microorganisms in FF of infertile women may have different effects on IVF outcomes. The Lactobacillus spp. may have a positive effect, while other microorganisms may have the opposite effect.

The role of serology, antibiotic susceptibility testing and serovar determination in genital chlamydial infections

Systemic and local antibodies regularly develop in genital infections caused by Chlamydia trachomatis. Such antibodies cannot be used as a sign of current infection as they often persist for years after the infection has resolved. Chlamydial antibodies have, however, been extremely useful for demonstrating associations between C. trachomatis and clinical conditions such as ectopic pregnancy and tubal factor infertility. In particular, antibodies to the chlamydial heat shock protein 60 predict the presence of tubal scarring.C. trachomatis has been divided into 15 (or 18) serovars, with many genotypes within each serovar. Differences in pathogenicity between serovars have been reported but no general pattern has emerged. Genotyping is a powerful epidemiological tool but is not yet ready for routine clinical use.C. trachomatis infections can be successfully treated by tetracycline or macrolides. Some resistant strains have been reported, causing treatment failures, and the problem of emerging antibiotic resistance cannot be neglected.