Association between anti-chlamydial immunity and IVF outcome

Müller, V; Savicheva, Alevtina; Kogan, Igor Yu.; Shalepo, Kira V.; Федорова, И. М.; Lesik, Elena A.; Shilnikova, Evgenia Mikhailovna; Bogdanova, Maria; Gzgzyan, Aleksandr M.

doi:10.3109/09513590.2015.1086513

Cited by 4 publications

(11 citation statements)

References 27 publications

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“…In contrast to other reports [9][10]26], in our center study, there was no statistical evidence of association between ectopic pregnancy and background factors (age, infertility duration, history of ectopic pregnancy), BMI, and parameters of ovarian stimulation. Aspects of the transfer technique (injection pressure, volume, location of the catheter tip), postulated to be contributing factors of EP occurrence, are unified in our practice, thus, could not be evaluated.…”

Section: Discussioncontrasting

confidence: 99%

“…Even excluding the study with the most weight and patient population [9] (possibly effecting the results) the RR remained similar: RR ¼ 0.9, 95%CI: 0.60-1.37, random effect model. Furthermore, the elimination of articles reporting data from national registers [15,17,18] did not influence the results: RR ¼ 0.82, 95%CI: 0.49-1.37, random effect model.…”

Section: Meta-analysismentioning

confidence: 89%

“…This suggestion is based on the physiology of human implantation, in which embryo enters uterine cavity on blastocyst development stage, and when being transferred to the uterus during IVF cycle, has a larger diameter, shorter time before implantation and a lower likelihood of migration to fallopian tube [4,9,24]. Decreased uterine contractility (cervix-to-fundus) due to progesterone influence in the luteal phase (day 6-7 after oocyte pick up) has also been postulated as a factor minimizing the retrograde travel of the embryo [16,22].…”

Section: Discussionmentioning

confidence: 99%

“…Pelvic inflammatory disease, tubal pathology, previous pelvic surgery, and uterine cavity abnormalities have been defined as factors mostly contributing to the risk of ectopic pregnancy in women with infertility [7,8]. Among other predisposing agents, smoking, uterine fibroids, endometriosis, obesity, advanced maternal age, and history of a prior ectopic pregnancy have been raised, thus remain contradictory [4,9,10].…”

Section: Introductionmentioning

confidence: 99%

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Ectopic pregnancy followingin vitrofertilization: meta-analysis and single-center experience during 6 years

Müller

Makhmadalieva

Kogan

et al. 2016

Gynecological Endocrinology

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Background: Ectopic pregnancy (EP) has been reported to occur in 1.4-5.4% of all clinical pregnancies resulting from in vitro fertilization (IVF) and embryo transfer (ET). Data on factors associated with abnormal embryo implantation following assisted conception are limited. Materials and methods: A systematic review and meta-analysis was performed to determine whether there is an association between the day (cleavage-stage, D3, versus blastocyst, D5) or the type (fresh versus frozen/thawed) of ET and EP rate. Risk factors for EP were evaluated in a retrospective study of 1194 women, who achieved pregnancy at our IVF unit between 2010 and 2016. Results: Sixteen papers were considered for the meta-analysis. EP rate did not differ between D3 and D5 fresh ET groups (RR ¼ 0.99, 95%CI: 0.76-1.30) and was higher after fresh versus frozen ET (RR ¼ 1.56, 95%CI: 1.25-1.95). At our clinic, 21 (1.76%) pregnancies were documented as ectopic. The risk of EP was associated with tubal pathology (OR ¼ 3.37, 95%CI: 1.39-8.2), previous appendectomy and past chlamydial infection. Conclusions: Present meta-analysis suggests that EP rate is similar following fresh blastocyst and cleavage ETs, but is significantly reduced after frozen compared with fresh ET. Our own findings demonstrate that tubal pathology has the major impact on EP occurrence following assisted conception.

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Section: Discussioncontrasting

confidence: 99%

Section: Meta-analysismentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ectopic pregnancy followingin vitrofertilization: meta-analysis and single-center experience during 6 years

Müller

Makhmadalieva

Kogan

et al. 2016

Gynecological Endocrinology

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“…Infection with Chlamydia trachomatis is an important sexually transmitted condition related to tubal infertility with increased salpingitis episodes that leads to tubal blockage [1][2][3]. Many studies revealed that serologic evidence of previous Chlamydia infection is exceptionally related to tubal infertility [4][5][6][7][8] and also decreased the success rate of a positive outcome for in vitro fertilization (IVF) [9]. The individuals with positive serology to chlamydia are at higher risk of developing the pelvic inflammatory disease (PID) [10,11].…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study to Analyze the Specificity of Chlamydial Heat Shock Protein (Chsp60) Antibodies to Diagnose Tubal Infertility

et al. 2021

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The aim: To investigate the utility of testing for chlamydial heat shock protein 60 (CHSP60) antibodies in the diagnosis of tubal infertility. Materials and methods: All the collected samples were assayed for IgM and IgG antibodies to chlamydia trachomatis and chlamydial heat shock protein 60 (CHSP60) by using immunofluorescence and enzyme-linked immunosorbent assay (ELISA) techniques, respectively. Results: There were no substantial differences between antibodies to C. trachomatis in females with tubal infertility (67%) and non-tubal infertility (48%). However, women with tubal infertility (45%) have more anti-CHSP60 antibodies than non-tubal infertility (9%). Antibody screening for C. trachomatis has only (63%) sensitivity and (54%) specificity for detecting tubal infertility. On the other hand, the CHSP60 antibody testing has (44%) sensitivity and 92% specificity for diagnosing tubal infertility. A positive microimmunofluorescence (MIF) titer was observed in 12 of 18 (67%) females with the tubal problem, 31 of 64 (48%) with non-tubal infertility (P=0.3, OR=2.2, 95% CI=0.71 to 8.01). The CHSP60 antibodies were found in 8 of 18 (45%) females with tubal problem & 6 of 64 (9%) women with non-tubal infertility, power factor alpha α P=0.004, OR=9.3, 95% CI=2.1 to 43.2, power= 1.002 for n= 0.05). Incorporating CHSP60 and C. trachomatis antibodies testing gives an excellent positive probability proportion of 10 to diagnose C. trachomatis associated tubal infertility. Conclusions: CHSP60 antibody testing is a more specific evaluation than antibody testing for C. trachomatis for predicting chlamydia-associated tubal infertility. Using these tests at the first infertility examination may help the immediate diagnosis for non-interceptive tubal infertility.

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Top‐quality embryo transfer is associated with lower odds of ectopic pregnancy

Anzhel

Mäkinen²,

Tinkanen

et al. 2022

Acta Obstet Gynecol Scand

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Introduction The incidence of ectopic pregnancy is up to four times higher after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) than in spontaneous pregnancies, and the risk of ectopic pregnancy is increased by tubal factor infertility and the transfer of multiple embryos. However, the effect of embryo quality on the probability of ectopic pregnancy has not been investigated until now and it is not clear whether ovarian stimulation parameters affect the incidence of ectopic pregnancy. Material and Methods An historical cohort study of 15 006 clinical pregnancies (diagnosed by ultrasound at 6–8 gestational weeks) after non‐donor IVF/ICSI with fresh embryo transfer (n = 8952) or frozen–thawed embryo transfer (n = 6054). Treatments were performed during 2000–2017 in Finland. A total of 9207 (61.4%) single and 5799 (38.6%) double embryo transfers of no more than one top‐quality embryo were evaluated. We analyzed the effects of multiple factors on ectopic pregnancy by logistic regression, including type of cycle (fresh vs frozen embryo transfer), female age, number and quality of embryos transferred, tubal factor infertility and factors of ovarian response to gonadotropin stimulation. Results Ectopic pregnancy was observed in 2.3% of cycles. There was no significant difference in ectopic pregnancy rate after fresh embryo transfer and frozen embryo transfer (2.2% vs 2.4%, p = 0.3). The ectopic pregnancy rate was lower in cycles with top‐quality embryo transfer (1.9%) than of those where only non‐top quality embryos were transferred (2.7%, p < 0.0001). Tubal factor infertility was diagnosed more often in ectopic pregnancy than in intrauterine pregnancies (21.2% vs 11.0%, p < 0.0001). Logistic regression revealed lower odds for ectopic pregnancy after a top‐quality embryo transfer than after transfer of a non‐top quality embryo (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.56–0.92, p = 0.007). Transfer of two vs one embryo (OR 1.35, 95% CI 1.05–1.70, p = 0.02) and tubal factor infertility (OR 2.21, 95% CI 1.68–2.91, p < 0.0001) significantly increased the risk of ectopic pregnancy. Conclusions Transfer of non‐top quality embryos is associated with a higher rate of ectopic pregnancy. This is particularly important to keep in mind in treatments with only non‐top embryos available even in the absence of tubal factor infertility. To minimize the risk of ectopic pregnancy, the number of embryos transferred should be as low as possible.

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Association between anti-chlamydial immunity and IVF outcome

Cited by 4 publications

References 27 publications

Ectopic pregnancy followingin vitrofertilization: meta-analysis and single-center experience during 6 years

Ectopic pregnancy followingin vitrofertilization: meta-analysis and single-center experience during 6 years

A Prospective Study to Analyze the Specificity of Chlamydial Heat Shock Protein (Chsp60) Antibodies to Diagnose Tubal Infertility

Top‐quality embryo transfer is associated with lower odds of ectopic pregnancy

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