Influence of bacterial vaginosis on conception and miscarriage in the first trimester: cohort study

Ralph, S G; Rutherford, Alison; Wilson, J D

doi:10.1136/bmj.319.7204.220

Cited by 252 publications

(177 citation statements)

References 15 publications

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“…An increased risk of pregnancy loss prior to the sixth week of gestation was also reported in women with bacterial vaginosis (BV) undergoing in vitro fertilization treatment [14,15]. The decrease in live birth rate following IVF in women with catheter tip contamination as well as in women with BV, may be caused by decreased conception rates, increased pregnancy loss, or both.…”

Section: Introductionmentioning

confidence: 95%

Examination of bacterial contamination at the time of embryo transfer, and its impact on the IVF/pregnancy outcome

Selman

Mariani

Barnocchi

et al. 2007

J Assist Reprod Genet

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Purpose This study was designed to examine the effect of bacterial contamination on in vitro fertilization treatment outcomes. Method In a prospective clinical trial, 152 patients aged 23-38 years, mean 33.3±4.6, undergoing IVF treatment were selected for this study. During embryo transfer, separate samples were collected for microbial examination from the following sites: the fundus of the vagina, the cervix, the embryo culture medium prior and post-embryo transfer, the tip of the catheter, and the external sheet. All the samples were separately cultured to identify any bacteria or yeast present. Results Pregnancy rates in patients testing positive for Entrobacteriaceae (22.2% versus 51%) and Staphylococcus species (17.6% versus 44%) were significantly lower than those in the negative culture group ( p< 0.001). The pregnancy rates do not seem to be affected by the other isolated microorganisms.Conclusion This study shows that the presence of vaginalcervical microbial contamination at the time of embryo transfer is associated with significantly decreased pregnancy rates.

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Section: Introductionmentioning

confidence: 95%

Examination of bacterial contamination at the time of embryo transfer, and its impact on the IVF/pregnancy outcome

Selman

Mariani

Barnocchi

et al. 2007

J Assist Reprod Genet

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“…The women were simultaneously screened for coexistent sexually transmitted infections. The full methodology and results of the IVF have been described elsewhere 9 . Two independent observers (JDW and SGR) read the slides.…”

Section: Methodsmentioning

confidence: 99%

Rates of bacterial vaginosis in women undergoing in vitro fertilisation for different types of infertility

Wilson¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective To assess whether the rate of bacterial vaginosis (BV) is higher in women with tubal factor infertility compared with those with other causes of infertility. Design Cross-sectional study.Setting Assisted conception unit of a teaching hospital in Leeds.Population Consecutive women undergoing in vitro fertilisation. Results A total of 749 women were included. The vaginal smears were normal in 63.6%, intermediate in 12.1%, and BV in 24.3%. The rates of BV in women with different types of infertility were 36.4% in tubal factor, 15.6% in male factor, 33.3% in anovulation, 12.5% in endometriosis and 18.9% in unexplained infertility. After controlling for the effects of age and smoking using a multivariate logistic regression model, women with tubal infertility were significantly more likely to have BV than women with endometriosis OR 3.63 (95% CI 1.52 -8.67); male factor OR 2.98 (95% CI 1.80 -4.90); and unexplained infertility OR 2.20 (95% CI 1.35 -3.59). The adjusted figures for the increase of BV in women with anovulation were: endometriosis OR 3.77 (95% CI 1.28 -11.08); male factor OR 3.09 (95% CI 1.37-6.96); and unexplained infertility OR 2.29 (95% CI 1.02 -5.12). Conclusions Women with tubal infertility were three times more likely to have BV than women with endometriosis, male factor or unexplained infertility. These findings support the association between BV, pelvic inflammatory disease (PID) and tubal damage but do not help distinguish between cause and effect. Women with anovulation were also three times more likely to have BV than women with endometriosis or male factor infertility, supporting suggestions of hormonal influence on vaginal flora.

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“…Episodes of BV commonly span several days to weeks [10] and the incidence of BV ranges from 5-30% in women of child bearing age in North America to over 50% in some populations [11][12][13]. BV has several severe consequences including increasing the risk of preterm birth, miscarriage and pelvic inflammatory disease [14][15][16]. BV also increases the risk of infection with human immunodeficiency virus (HIV) and herpes simplex virus type 2 [13,17,18].…”

Section: Introductionmentioning

confidence: 99%

Dendritic cell activation and maturation induced by mucosal fluid from women with bacterial vaginosis

John

Martinson

Simões

et al. 2007

Clinical Immunology

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Dendritic cells (DC) at mucosal surfaces mature when exposed to "danger" signals such as LPS. Bacterial vaginosis (BV) is a prevalent alteration of the vaginal bacterial flora associated with preterm childbirth and increased risk for HIV acquisition. We examined the effect of mucosal fluid from women with BV or healthy flora on DC function. IL-12, IL-23 and p40 production by monocytederived dendritic cells (MDDC) were all induced by BV samples. Activation/maturation markers HLA-DR, CD40, and CD83 on MDDC incubated with BV CVL were also induced. BV CVL also decreased the endocytic ability of MDDC and increased proliferation of T-cells in allogeneic MLR. Plasmacytoid dendritic cell (pDC) CD86 expression was induced by BV CVL. Healthy flora CVL had little effect in any of the tests. This study suggests that BV, but not healthy flora, affects local dendritic cell function in vivo suggesting a mechanism through which BV affects mucosal immunity.

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Influence of bacterial vaginosis on conception and miscarriage in the first trimester: cohort study

Cited by 252 publications

References 15 publications

Examination of bacterial contamination at the time of embryo transfer, and its impact on the IVF/pregnancy outcome

Examination of bacterial contamination at the time of embryo transfer, and its impact on the IVF/pregnancy outcome

Rates of bacterial vaginosis in women undergoing in vitro fertilisation for different types of infertility

Dendritic cell activation and maturation induced by mucosal fluid from women with bacterial vaginosis

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