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P Córdova AL, Z M Fontanella S, Colonetti T, Rodrigues Uggioni ML, Grande AJ, Saggioratto MC, Schmitt Testoni E, Rosa MI. Role of vulvovaginal candidiasis infection in infertility: systematic review and meta-analysis. Braz J Microbiol 2024; 55:65-74. [PMID: 38153623 PMCID: PMC10920545 DOI: 10.1007/s42770-023-01225-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 12/14/2023] [Indexed: 12/29/2023] Open
Abstract
OBJECTIVE To evaluate the relationship between fungal infection in the female genital tract and infertility. DATA SOURCES A systematic review was carried out, and the search was conducted in Medline, Embase, Web of Science, Google Scholar, and Cochrane Library databases until August 2022. The search strategy used standardized keywords such as "candidiasis" and "infertility," combined with their respective synonyms. The search was limited to human studies, with no language restrictions. STUDY ELIGIBILITY CRITERIA Primary articles that evaluated women of reproductive age with and without infertility and related to the presence or absence of candidiasis were included. STUDY APPRAISAL AND SYNTHESIS METHODS For the analyses, the odds ratio association measure was used with a confidence interval of 95% using RevMan software (version 5.4). RESULTS Eight studies, published between 1995 and 2021 in different countries around the world, were included in this systematic review. Two studies were excluded after sensitivity analysis. A total of 909 participants were included in the group of infertile women and 2363 women in the control group. The age of the evaluated women varied between 18 and 50 years. The random effect model was used and showed no significant difference when comparing candidiasis between fertile and infertile women (odds ratio: 1.44; 95% confidence interval 0.86, 2.41 p= 0.17). CONCLUSIONS There was no association between candidiasis and female sterility.
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Affiliation(s)
- Ana Luiza P Córdova
- Gynecology and Obstetrics Medical Residency Program, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Stéfani Z M Fontanella
- Gynecology and Obstetrics Medical Residency Program, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Tamy Colonetti
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Maria Laura Rodrigues Uggioni
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Antonio José Grande
- Laboratory of Evidence-Based Practice, Universidade Estadual do Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Maria Carolina Saggioratto
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Eduardo Schmitt Testoni
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Maria Inês Rosa
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil.
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Magill RG, MacDonald SM. Male infertility and the human microbiome. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1166201. [PMID: 37361341 PMCID: PMC10289028 DOI: 10.3389/frph.2023.1166201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
The historical belief in urology was that the genitourinary system should be sterile in a normal, healthy, asymptomatic adult. This idea was perpetuated for decades until research revealed a diverse microbiota existing in human anatomical niches that contributed to both human health and disease processes. In recent years, the search for an etiology and modifiable risk factors in infertility has turned to the human microbiome as well. Changes in the human gut microbiome have been associated with changes in systemic sex hormones and spermatogenesis. Certain microbial species are associated with higher levels of oxidative stress, which may contribute to an environment higher in oxidative reactive potential. Studies have demonstrated a link between increased oxidative reactive potential and abnormal semen parameters in infertile men. It has also been hypothesized that antioxidant probiotics may be able to correct an imbalance in the oxidative environment and improve male fertility, with promising results in small studies. Further, the sexual partner's microbiome may play a role as well; studies have demonstrated an overlap in the genitourinary microbiomes in sexually active couples that become more similar after intercourse. While the potential applications of the microbiome to male fertility is exciting, there is a need for larger studies with uniform microbial sequencing procedures to further expand this topic.
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Affiliation(s)
- Resa G. Magill
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Susan M. MacDonald
- Department of Urology, The Pennsylvania State University College of Medicine, Hershey, PA, United States
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3
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Morawiec E, Czerwiński M, Czerwińska AB, Wiczkowski A. Semen dysbiosis—just a male problem? Front Cell Infect Microbiol 2022; 12:815786. [PMID: 36176582 PMCID: PMC9514095 DOI: 10.3389/fcimb.2022.815786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Seminal microflora is crucial to male fertility. Dysbiosis—disturbance of quantitative ratios of individual bacteria or appearance of pathogenic species—rarely results in symptomatic disease. Inflammation results in decreased sperm production, lower motility, or morphological changes and, in the long term, can cause ejaculatory duct obstruction, leading to infertility. Moreover, it may cause infection of the partner’s female genital tract. Dysbiosis in both partners results in fertility problems, disorders in embryo implantation, or miscarriages. In addition, chronic inflammation of the male genitourinary system may accelerate the appearance of antisperm antibodies. A comprehensive examination of seminal microflora can clarify the causes of infertility or prevent pathological conditions that affect seminal parameters. Seminal microflora as a direct impact on fertility problems as well as a decrease in the effectiveness of assisted reproduction methods, insemination, or in vitro procedures.
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Affiliation(s)
- Emilia Morawiec
- Department of Microbiology, Faculty of Medicine, University of Technology in Katowice, Katowice, Poland
- Gyncentrum Sp. z o.o. Laboratory of Molecular Biology and Virology, Katowice, Poland
- Department of Histology, Cytophysiology and Embryology, Faculty of Medicine, University of Technology in Katowice, Katowice, Poland
- *Correspondence: Emilia Morawiec,
| | - Michał Czerwiński
- Gyncentrum Sp. z o.o. Laboratory of Molecular Biology and Virology, Katowice, Poland
- American Medical Clinic, Katowice, Poland
| | - Anna Bednarska- Czerwińska
- Gyncentrum Sp. z o.o. Laboratory of Molecular Biology and Virology, Katowice, Poland
- Faculty of Medicine, University of Technology in Katowice, Katowice, Poland
| | - Andrzej Wiczkowski
- Department of Microbiology, Faculty of Medicine, University of Technology in Katowice, Katowice, Poland
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Okwelogu SI, Ikechebelu JI, Agbakoba NR, Anukam KC. Microbiome Compositions From Infertile Couples Seeking In Vitro Fertilization, Using 16S rRNA Gene Sequencing Methods: Any Correlation to Clinical Outcomes? Front Cell Infect Microbiol 2021; 11:709372. [PMID: 34660337 PMCID: PMC8517523 DOI: 10.3389/fcimb.2021.709372] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/08/2021] [Indexed: 01/22/2023] Open
Abstract
Background Bacterial infections are usually suspected in infertile couples seeking IVF with no clear understanding of the microbial compositions present in the seminal fluids and vaginal niche of the patients. We used next-generation sequencing technology to correlate microbiota compositions with IVF clinical outcomes. Methods Thirty-six couples were recruited to provide seminal fluids and vaginal swabs. Bacterial DNA was extracted, and V4 region of the 16S rRNA was amplified and sequenced in a pair-end configuration on the Illumina MiSeq platform rendering 2 × 150 bp sequences. Microbial taxonomy to species level was generated using the Greengenes database. Linear discriminant analysis (LDA) effect size (LEfSe) was used to identify biologically and statistically significant differences in relative abundance. Results Seminal fluid microbiota compositions had lower bacterial concentrations compared with the vagina, but species diversity was significantly higher in seminal fluid samples. Azoospermic subjects had more relative abundance of Mycoplasma and Ureaplasma. In Normospermic semen, Lactobacillus (43.86%) was the most abundant, followed by Gardnerella (25.45%), while the corresponding vaginal samples, Lactobacillus (61.74%) was the most abundant, followed by Prevotella (6.07%) and Gardnerella (5.86%). Conclusions Semen samples with positive IVF were significantly colonized by Lactobacillus jensenii (P=0.002), Faecalibacterium (P=0.042) and significantly less colonized by Proteobacteria, Prevotella, Bacteroides, and lower Firmicutes/Bacteroidetes ratio compared with semen samples with negative IVF. Vaginal samples with positive IVF clinical outcome were significantly colonized by Lactobacillus gasseri, less colonized by Bacteroides and Lactobacillus iners. This study has opened a window of possibility for Lactobacillus replenishments in men and women before IVF treatment.
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Affiliation(s)
- Somadina I Okwelogu
- Department of Medical Laboratory Science, Faculty of Health Sciences & Technology, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Joseph I Ikechebelu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Nneka R Agbakoba
- Department of Medical Laboratory Science, Faculty of Health Sciences & Technology, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Kingsley C Anukam
- Department of Medical Laboratory Science, Faculty of Health Sciences & Technology, Nnamdi Azikiwe University, Nnewi, Nigeria.,Department of Pharmaceutical Microbiology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria.,Department of Research and Development, Uzobiogene Genomics, London, ON, Canada
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5
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Moradi Alamdarloo S, Razavi B, Motamedifar M, Hashemi A, Samsami A, Homayoon N, Ghasempour L, Davoodi S, Homayoon H, Mohebi S, Hadadi M, Hessami K. The effect of endocervical and catheter bacterial colonisation during in vitro fertilisation and embryo transfer (IVF-ET) on IVF success rate among asymptomatic women: a longitudinal prospective study. J OBSTET GYNAECOL 2021; 42:333-337. [PMID: 34151685 DOI: 10.1080/01443615.2021.1909548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The adverse effects of bacterial contamination during in vitro fertilisation and embryo transfer (IVF-ET) have been studied previously. However, data on asymptomatic women with positive bacterial culture and their IVF outcome are lacking. This prospective longitudinal study was conducted on 74 women undergoing IVF-ET, of whom specimens from the endocervix and ET catheter were taken and sent to a laboratory for microbiological assessment. Then, patients were followed up for evaluation of chemical pregnancy (β-HCG > 25 mIU/mL) and clinical pregnancy (detected foetal heartbeat). The findings revealed that there was no significant difference in terms of biochemical (35.4% vs. 19.2%, p= .116) and clinical pregnancy rate (25.0% vs. 15.4%, p= .257) among ET catheter culture positive and negative women. This finding allows us to conclude that the positive culture in the absence of clinical signs of infection may not increase the risk of implantation failure.Impact StatementWhat is already known on this subject? There is growing evidence indicating that endometritis may decrease the endometrial receptiveness in in vitro fertilisation (IVF) cycles; however, there is a paucity of knowledge regarding IVF outcomes when the bacterial culture of embryo transfer (ET) catheter is positive.What the results of this study add? The present study demonstrates that positive ET catheter culture in asymptomatic women does not increase the risk of IVF failure.What the implications are of these findings for clinical practice and/or further research? Positive-culture, per se, may not be associated with poor IVF outcomes and further studies should be undertaken on this topic in various clinical settings using different protocols.
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Affiliation(s)
| | - Behnaz Razavi
- Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Motamedifar
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Atefe Hashemi
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alamtaj Samsami
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Homayoon
- Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Ghasempour
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Davoodi
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamide Homayoon
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samane Mohebi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahtab Hadadi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Hessami
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Tomaiuolo R, Veneruso I, Cariati F, D’Argenio V. Microbiota and Human Reproduction: The Case of Male Infertility. High Throughput 2020; 9:E10. [PMID: 32294988 PMCID: PMC7349524 DOI: 10.3390/ht9020010] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/03/2020] [Accepted: 04/09/2020] [Indexed: 02/06/2023] Open
Abstract
The increasing interest in metagenomics is enhancing our knowledge regarding the composition and role of the microbiota in human physiology and pathology. Indeed, microbes have been reported to play a role in several diseases, including infertility. In particular, the male seminal microbiota has been suggested as an important factor able to influence couple's health and pregnancy outcomes, as well as offspring health. Nevertheless, few studies have been carried out to date to deeper investigate semen microbiome origins and functions, and its correlations with the partner's reproductive tract microbiome. Here, we report the state of the art regarding the male reproductive system microbiome and its alterations in infertility.
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Affiliation(s)
- Rossella Tomaiuolo
- KronosDNA srl, spinoff of Università Federico II, 80133 Napoli, Italy; (R.T.); (F.C.)
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy;
- CEINGE-Biotecnologie Avanzate scarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy
| | - Iolanda Veneruso
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy;
- CEINGE-Biotecnologie Avanzate scarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy
| | - Federica Cariati
- KronosDNA srl, spinoff of Università Federico II, 80133 Napoli, Italy; (R.T.); (F.C.)
- CEINGE-Biotecnologie Avanzate scarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy
| | - Valeria D’Argenio
- CEINGE-Biotecnologie Avanzate scarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy
- Department of Human Sciences and Quality of Life Promotion, San Raffaele Open University, 00166 Roma, Italy
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7
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Does bacterial colonization during embryo transfer have an impact on pregnancy rate in ICSI? : Tunisian preliminary results. J Gynecol Obstet Hum Reprod 2020; 50:101727. [PMID: 32173629 DOI: 10.1016/j.jogoh.2020.101727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 02/17/2020] [Accepted: 03/03/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Embryos' transfer into the uterine cavity remains a limiting factor in the success of intracytoplasmic sperm injection (ICSI). This study aimed to evaluate the impact of cervico-vaginal colonization on ICSI outcomes. MATERIEL AND METHODS Longitudinal, prospective and analytical study, conducted from February 1 st to October 31 st, 2017. On the day of embryos' transfer, patients with the following criteria were included: Age ≤ 40, normal uterine ultrasound and hysteroscopy, first or second attempt of ICSI, use of fresh semen and transfer of at least one good quality embryo. Three samples were done for microbiological analysis: vaginal secretions, cervical mucus and the tip of the transfer catheter. RESULTS The study included 40 patients. Pregnancy rate was 52.5 %. Catheter contamination occurred in nine cases (22.5 %). The most frequently isolated bacteria were Streptococcus anginosus (37 % of cases), Gardnerella vaginalis (27 % of cases) and Streptococcus agalactiae (18 % of cases). In all cases of contamination, the same bacteria were found also in the vagina and cervical mucus. In cases of contamination with Gardnerella vaginalis, the study of vaginal flora showed bacterial vaginosis. No pregnancy was obtained when contamination of the transfer catheter occurred. In the absence of contamination, pregnancy rate was 61.2 % (ρ = 0.003). Both populations (patients with catheter contamination and patients without catheter contamination) were comparable regarding epidemiological characteristics and ICSI attempt data. CONCLUSION Contamination of the transfer catheter by cervical-vaginal bacteria appears to affect IVF results. Systematic antibiotic prophylaxis could be proposed to reduce this negative impact.
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Amato V, Papaleo E, Pasciuta R, Viganò P, Ferrarese R, Clementi N, Sanchez AM, Quaranta L, Burioni R, Ambrosi A, Salonia A, Clementi M, Candiani M, Mancini N. Differential Composition of Vaginal Microbiome, but Not of Seminal Microbiome, Is Associated With Successful Intrauterine Insemination in Couples With Idiopathic Infertility: A Prospective Observational Study. Open Forum Infect Dis 2019; 7:ofz525. [PMID: 31915713 PMCID: PMC6942492 DOI: 10.1093/ofid/ofz525] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 12/09/2019] [Indexed: 12/13/2022] Open
Abstract
Background Vaginal and seminal microbiomes have gained increasing interest for their involvement in reproductive health and fertility. However, their role in reproductive outcome is not fully understood yet. In this study, we aimed to correlate the vaginal and the seminal microbiome of 23 couples with idiopathic infertility to the clinical pregnancy rate after intrauterine insemination (IUI). Methods Vaginal swabs and seminal fluids were collected on the day of IUI procedure and analyzed through polymerase chain reaction amplification of variable regions 3 and 4 (V3–V4) of 16S ribosomal ribonucleic acid genes and Illumina MiSeq sequencing. The taxonomic data were then correlated to IUI success. Results Idiopathic infertile women showed a different average composition of vaginal microbiome compared with control sequences, whereas for seminal counterpart no relevant differences were observed. Furthermore, among idiopathic infertile women, different patterns of Lactobacillus species dominations were observed, with a predominance either of Lactobacillus crispatus, a marker of a healthy vaginal ecosystem, or of Lactobacillus iners and Lactobacillus gasseri, associated with a more dysbiosis-prone environment. More important, considering all investigated variables, vaginal L crispatus domination was the only factor strongly associated to IUI success (P = .0002). Conclusions Our results strengthen the potential role of L crispatus in promoting a favorable environment for pregnancy and suggest that microbiome characterization could be useful, together with standard clinical and laboratory assessments, in the pre-IUI evaluation of infertile couples.
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Affiliation(s)
- Virginia Amato
- Microbiology and Virology Unit, "Vita-Salute" San Raffaele University, Milan, Italy
| | - Enrico Papaleo
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Renée Pasciuta
- Microbiology and Virology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Viganò
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Ferrarese
- Microbiology and Virology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Clementi
- Microbiology and Virology Unit, "Vita-Salute" San Raffaele University, Milan, Italy
| | - Ana Maria Sanchez
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lavinia Quaranta
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Burioni
- Microbiology and Virology Unit, "Vita-Salute" San Raffaele University, Milan, Italy
| | - Alessandro Ambrosi
- Faculty of Medicine and Surgery, "Vita-Salute" San Raffaele University, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Massimo Clementi
- Microbiology and Virology Unit, "Vita-Salute" San Raffaele University, Milan, Italy.,Microbiology and Virology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Department of Obstetrics and Gynecology, "Vita-Salute" San Raffaele University School of Medicine, IRCCS, Ospedale San Raffaele, Milan, Italy
| | - Nicasio Mancini
- Microbiology and Virology Unit, "Vita-Salute" San Raffaele University, Milan, Italy.,Microbiology and Virology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Altmäe S, Franasiak JM, Mändar R. The seminal microbiome in health and disease. Nat Rev Urol 2019; 16:703-721. [PMID: 31732723 DOI: 10.1038/s41585-019-0250-y] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2019] [Indexed: 12/19/2022]
Abstract
Owing to the fact that there are more microbial than human cells in our body and that humans contain more microbial than human genes, the microbiome has huge potential to influence human physiology, both in health and in disease. The use of next-generation sequencing technologies has helped to elucidate functional, quantitative and mechanistic aspects of the complex microorganism-host interactions that underlie human physiology and pathophysiology. The microbiome of semen is a field of increasing scientific interest, although this microbial niche is currently understudied compared with other areas of microbiome research. However, emerging evidence is beginning to indicate that the seminal microbiome has important implications for the reproductive health of men, the health of the couple and even the health of offspring, owing to transfer of microorganisms to the partner and offspring. As this field expands, further carefully designed and well-powered studies are required to unravel the true nature and role of the seminal microbiome.
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Affiliation(s)
- Signe Altmäe
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Granada, Spain. .,Competence Centre on Health Technologies, Tartu, Estonia. .,Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain.
| | | | - Reet Mändar
- Competence Centre on Health Technologies, Tartu, Estonia.,Department of Microbiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
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Xie QZ, Xu WM, Qi QR, Luo ZL, Dong L. Patients with cervical Ureaplasma Urealyticum and Chlamydia Trachomatis infection undergoing IVF/ICSI-ET: The need for new paradigm. ACTA ACUST UNITED AC 2016; 36:716-722. [PMID: 27752891 DOI: 10.1007/s11596-016-1650-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/07/2016] [Indexed: 11/28/2022]
Abstract
Genital tract infections with ureaplasma urealyticum (UU) and chlamydia trachomatis (CT) are the most frequent sexually-transmitted disease worldwide. UU and CT infections are considered to be the leading cause for infertility and adverse pregnancy outcomes. However, little is known about the specific effect of cervical UU and CT infections on the etiology of female infertility, as well as the pregnancy outcomes of the patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). In order to find the association between cervical UU and/or CT infection and pregnancy outcomes, we conducted a retrospective case-control study on the patients undergoing IVF/ICSI-ET with cervical UU and/or CT infection. A total of 2208 patients who received IVF/ICSI-ET were enrolled in this study. Data on the general conditions, pregnancy history and clinical pregnant outcomes were analyzed in terms of the cervical UU and CT detection. Our results revealed that cervical UU and CT infections were the risk factors for ectopic pregnancy and tubal factor-induced infertility. Moreover, the pregnancy rate, abortion rate, ectopic pregnancy rate and premature birth rate in patients with UU and/or CT infections showed no significant difference when compared with the control group. We recommend that cervical UU and CT detection should be an optional item for infertility patients and clinical UU detection should differentiate the subtypes of cervical UU. Positive cervical UU and CT infections should not be taken as strict contraindications for IVF/ICSI-ET.
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Affiliation(s)
- Qing-Zhen Xie
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Wang-Ming Xu
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
| | - Qian-Rong Qi
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Zeng-Li Luo
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Lan Dong
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
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11
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Shu Y, Prokai D, Berga S, Taylor R, Johnston-MacAnanny E. Transfer of IVF-contaminated blastocysts with removal of the zona pellucida resulted in live births. J Assist Reprod Genet 2016; 33:1385-1388. [PMID: 27465300 DOI: 10.1007/s10815-016-0776-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 07/11/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Bacterial contamination may cause loss or damage to cultured oocytes or embryos, resulting in cancelation or delaying of a fresh embryo transfer. While live births have been reported following the transfer of embryos contaminated with yeast, very little information is available on how to handle embryos with bacterial contamination. We report two cases of successful pregnancy in patients with bacterial contamination of embryo culture dishes. METHODS We retrospectively reviewed 878 oocyte retrievals performed between January 2011 and December 2014. Bacterial contamination was recorded in two split IVF/ICSI cases, where contamination occurred in embryo culture drops containing embryos from conventional insemination but not from ICSI on day 3. RESULTS To minimize the adverse effects of bacterial contamination on transfer outcomes, we removed the zona pellucida of contaminated frozen blastocysts and successfully obtained clinical pregnancies following transfer of zona-free blastocysts that were previously contaminated during IVF culture. CONCLUSIONS Removal of the zona pellucida is an appropriate approach to handle blastocysts contaminated with bacteria during in vitro culture.
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Affiliation(s)
- Yimin Shu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Wake Forest University Baptist Medical Center, Winston Salem, NC, 27103, USA.
| | - David Prokai
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Wake Forest University Baptist Medical Center, Winston Salem, NC, 27103, USA
| | - Sarah Berga
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Wake Forest University Baptist Medical Center, Winston Salem, NC, 27103, USA
| | - Robert Taylor
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Wake Forest University Baptist Medical Center, Winston Salem, NC, 27103, USA
| | - Erika Johnston-MacAnanny
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Wake Forest University Baptist Medical Center, Winston Salem, NC, 27103, USA
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Eldivan Ö, Evliyaoğlu Ö, Ersoy E, Aksu G, Dilbaz S, Göktolga Ü. Does screening for vaginal infection have an impact on pregnancy rates in intracytoplasmic sperm injection cycles? Turk J Obstet Gynecol 2016; 13:11-15. [PMID: 28913082 PMCID: PMC5558349 DOI: 10.4274/tjod.56563] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 02/20/2016] [Indexed: 12/01/2022] Open
Abstract
Objective: Assisted reproduction techniques have become widespread worldwide. Considering their costs, physicians endeavor to improve pregnancy rates. Infections are one of the disrupting problems in this arena. We aimed to investigate the effects of screening for vaginal infection on pregnancy rates in intracytoplasmic sperm injection cycles. Materials and Methods: One hundred twenty patients randomized into two groups for this study. Patients were screened for vaginal infections in group 1, and no screening was performed in group 2. The assisted reproduction outcomes were investigated and compared between the two groups. Results: There was no significant difference between ages, or durations and causes of infertility of patients who conceived and of those who did conceive. Forty-five patients in group 1, and 40 patients in group 2 reached the embryo transfer stage. The rates of conception were 23.5% (n=4) in culture-positive patients (n=17), and 42.9% (n=12) in culture-negative patients (n=28) in group 1. There was no significant difference among patients who were not screened, screen-positive, and screen-negative, in terms of pregnancy rates. None of the patients had Neisseria gonorrhoeae or Trichomonas vaginalis. Bacterial vaginosis was detected in 13 patients, and both bacterial vaginosis and Chlamydia trachomatis were detected in 4 patients. Three of 4 patients who conceived screen-positive and 8 of 12 patients who conceived screen-negative delivered healthily at term. Conclusion: No significant difference was found between patients who were sampled for culture and patients who were not sampled in terms of pregnancy rates. Also, no difference was found between the patients who were culture-negative and patients who were treated with antimicrobials after a culture positive result. Further larger studies are warranted to clarify this issue.
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Affiliation(s)
- Özlem Eldivan
- Etlik Zübeyde Hanım Women's Healthcare Education and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Özlem Evliyaoğlu
- Etlik Zübeyde Hanım Women's Healthcare Education and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Ebru Ersoy
- Etlik Zübeyde Hanım Women's Healthcare Education and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Gönül Aksu
- Etlik Zübeyde Hanım Women's Healthcare Education and Research Hospital, Clinic of Microbiology, Ankara, Turkey
| | - Serdar Dilbaz
- Etlik Zübeyde Hanım Women's Healthcare Education and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Ümit Göktolga
- Etlik Zübeyde Hanım Women's Healthcare Education and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
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Complementary seminovaginal microbiome in couples. Res Microbiol 2015; 166:440-447. [DOI: 10.1016/j.resmic.2015.03.009] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 02/27/2015] [Accepted: 03/30/2015] [Indexed: 02/02/2023]
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14
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Motteram C, Vollenhoven B, Hope N, Osianlis T, Rombauts L. Live birth rates after combined adjuvant therapy in IVF–ICSI cycles: a matched case-control study. Reprod Biomed Online 2015; 30:340-8. [DOI: 10.1016/j.rbmo.2014.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 11/28/2014] [Accepted: 12/09/2014] [Indexed: 11/24/2022]
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Mändar R. Microbiota of male genital tract: Impact on the health of man and his partner. Pharmacol Res 2013; 69:32-41. [DOI: 10.1016/j.phrs.2012.10.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 10/16/2012] [Accepted: 10/29/2012] [Indexed: 10/27/2022]
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Boitrelle F, Robin G, Lefebvre C, Bailly M, Selva J, Courcol R, Lornage J, Albert M. Les bactériospermies en AMP : comment réaliser et interpréter une spermoculture ? Qui traiter ? Pourquoi ? Comment ? ACTA ACUST UNITED AC 2012; 40:226-34. [DOI: 10.1016/j.gyobfe.2012.01.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 12/12/2011] [Indexed: 11/26/2022]
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17
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Borovkova N, Korrovits P, Ausmees K, Türk S, Jõers K, Punab M, Mändar R. Influence of sexual intercourse on genital tract microbiota in infertile couples. Anaerobe 2011; 17:414-8. [PMID: 21549210 DOI: 10.1016/j.anaerobe.2011.04.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 04/06/2011] [Accepted: 04/09/2011] [Indexed: 10/18/2022]
Abstract
Several studies have suggested the association of disturbed genital tract microbiota with infertility. Our aim was to clarify the influence of sexual intercourse on partner's genital tract microbiota in infertile couples. Seventeen couples were studied, and in 5 men inflammatory prostatitis (IP) was diagnosed. Semen samples were collected during menstruation of the female counterpart, two self-collected vaginal samples were taken 3-5 days later - before intercourse and 8-12 h after intercourse. Ureaplasma parvum was found in 59% of women, its prevalence was higher in women whose partner had IP, as well as in half of their male partners. Sexual intercourse caused significant shifts in vaginal microbiota - increase of Nugent score and shifts in cultured microbiota (emergence and disappearance of several species). These changes were less expressed in the presence of normal vaginal microbiota but more prominent in the partners of IP men. These changes may interfere with fertilization.
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Klein JU, Missmer SA, Jackson KV, Orasanu B, Fox JH, Racowsky C. In vitro fertilization outcomes after transfer of embryos contaminated with yeast. Fertil Steril 2009; 91:294-7. [DOI: 10.1016/j.fertnstert.2007.11.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2005] [Revised: 11/14/2007] [Accepted: 11/14/2007] [Indexed: 11/30/2022]
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Wu HH, Yeh GP, Hsieh TC, Lin KC. Fulminant Sepsis after Second-Trimester Amniocentesis in Pregnant Women by in vitro Fertilization and Embryo Transfer. Fetal Diagn Ther 2007; 22:217-20. [PMID: 17228162 DOI: 10.1159/000098721] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2006] [Accepted: 05/24/2006] [Indexed: 11/19/2022]
Abstract
Second-trimester amniocentesis is a common procedure for prenatal diagnosis. Sepsis is a rare complication after amniocentesis and may rapidly deteriorate if prompt treatment, including broad-spectrum antibiotics and removal of the infected abortus, is delayed. In vitro fertilization and embryo transfer (IVF-ET) is a standard final treatment for infertile women. Transvaginal oocyte retrieval is necessary for such women; this procedure potentially causes Escherichia coli attaching and effacing in the abdominal cavity. Here we report that two pregnant women by IVF-ET developed sepsis after second-trimester amniocentesis. The cause of sepsis after amniocentesis is still unknown. We provided the possibility of the causation of the E. coli infection associated with the previous intra-abdominal procedure, but it needs more evidence to prove it.
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Affiliation(s)
- Hsin-Hung Wu
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan (ROC).
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Abstract
PURPOSE OF REVIEW Embryo transfer is arguably the most critical step in assisted reproduction. The purpose of this article is to review the different aspects of the procedure in the light of recent evidence. RECENT FINDINGS Randomized trials have shown that significantly higher pregnancy rates are obtained when embryo transfer is performed under ultrasound guidance, the embryos are deposited in the middle part of the uterine cavity, an atraumatic technique is used and when low-dose aspirin is routinely administered following the procedure. Blood in the catheter and leaving the embryos inside it for more than 120 s diminish the pregnancy rate significantly. Air in the catheter, immediate removal of the catheter, performing two transfers in the same cycle, prolonged bed rest, sexual intercourse after embryo transfer or the use of sildenafil do not affect the results. Based on currently available evidence, Cochrane reviews have concluded that the live birth rate is not increased by delaying embryo transfer from day two to three or to the blastocyst stage, and that single embryo transfer leads to lower live birth rates than the transfer of two embryos. The value of a mock transfer a few days before the actual procedure has been challenged as the position of the uterus may change. The effect of holding the cervix with a volsellum, routinely administering antibiotics and the superiority of one catheter over the others is still to be determined. SUMMARY Recent studies confirm the importance of the various aspects of embryo transfer. More randomized studies are needed to further evaluate them.
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Affiliation(s)
- Hassan N Sallam
- Department of Obstetrics and Gynaecology, University of Alexandria and Alexandria Fertility Center, Alexandria, Egypt.
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