Study of vaginal infections in women with infertility
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20243947Keywords:
Candida, Bacterial vaginosis, Infertility, Vaginal infectionsAbstract
Background: Infertility, being multifactorial in origin and complex to treat, the recognition, evaluation and treatment of infertility is complicated. Our study aimed at learning the association of vaginal infections and infertility and to compare the vaginal flora.
Methods: An analytic cross-sectional study was conducted to investigate the prevalence of vaginal infections among women with infertility and a control group. 230 participants were recruited from the outpatient department of an urban tertiary care hospital in Mumbai, India. Comprehensive assessments, including sociodemographic information, clinical evaluation, and vaginal swab analysis, were performed. Statistical analysis of the collected data revealed potential associations between vaginal infections and infertility.
Results: Our study found a significant association between vaginal infections and infertility, as noted by 50.4% and 22.6% being the prevalence of vaginal infections in infertility and control group respectively. The most common vaginal infection was bacterial vaginosis being 24.3% prevalent in infertile group and 13% in control group. The second most common vaginal infection was Candida- 13% in infertile women and 7.8% in control group. Other isolated pathogens included E. coli, Staphylococcus, Gonococcus, and Trichomonas. No significant association was found between vaginal infections and any specific implicated infertility factors.
Conclusions: In conclusion, preventing and treating vaginal infections is a critical aspect of infertility management. By implementing early detection, appropriate treatment, and preventive measures, couples can significantly improve their chances of achieving pregnancy.
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References
Melania R. Bacterial agents as a cause of infertility in humans. New Microbiol. 2016;39(3):206-9.
Ravel J, Moreno I, Simón C. Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease. Am J Obst and Gynaecol. 2021;2:251-7.
Witkin SS, Linhares IM, Giraldo P. Bacterial flora of the female genital tract: function and immune regulation. Best Pract Res Clin Obstet Gynaecol. 2021;4:341-54.
Brunham RC, Gottlieb SL, Paavonen J. Pelvic inflammatory disease. New England J Med. 2015;372(21):2039-48.
Babu G, Singaravelu BG, Srikumar R, Reddy SV. Comparative study on the vaginal flora and incidence of asymptomatic vaginosis among healthy women and in women with infertility problems of reproductive age. J Clin Diagn Res. 2017;11(8):18.
Ravel J, Moreno I, Simón C. Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease. Am J Obst Gynecol. 2021;224(3):251-7.
Ona S, Molina RL, Diouf K. Mycoplasma genitalium: an overlooked sexually transmitted pathogen in women. Infectious Dis Obst Gynecol. 2016;1:4513089.
Debattista J, Gazzard CM, Wood RN, Allan JA, Allan JM, Scarman A, Mortlock M, Timms P, Knox CL. Interaction of microbiology and pathology in women undergoing investigations for infertility. Infectious Dis Obst Gynecol. 2004;12(3-4):135-45.
Van Bergen JE, Hoenderboom BM, David S, Deug F, Heijne JC, Van Aar F, Hoebe CJ, Bos H, Dukers-Muijrers NH, Götz HM, Low N. Where to go to in chlamydia control? From infection control towards infectious disease control. Sexually transmitted infections. 2021;97(7):501-6.
Brotman RM, Klebanoff MA, Nansel TR, Andrews WW, Schwebke JR, Zhang J, Yu KF, Zenilman JM, Scharfstein DO. A longitudinal study of vaginal douching and bacterial vaginosis—a marginal structural modeling analysis. American journal of epidemiology. 2008;168(2):188-96.
Pellati D, Mylonakis I, Bertoloni G, Fiore C, Andrisani A, Ambrosini G, Armanini D. Genital tract infections and infertility. Europ J Obst Gynecol Reprod Biol. 2008;140(1):3-11.
Shaheen R. Infections and infertility. Ind J Pract doctor. 2005;2(5):11-2.
Ravel J, Moreno I, Simón C. Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease. Am J Obst Gynecol. 2021;224(3):251-7.
Park HJ, Kim YS, Yoon TK, Lee WS. Chronic endometritis and infertility. Clinical and experimental reproductive medicine. 2016;43(4):185.
Ricci S, De Giorgi S, Lazzeri E, Luddi A, Rossi S, Piomboni P, et al. Impact of asymptomatic genital tract infections on in vitro Fertilization (IVF) outcome. PloS one. 2018;13(11):207684.
Hong X, Ma J, Yin J, Fang S, Geng J, Zhao H, Zhu M, Ye M, Zhu X, Xuan Y, Wang B. The association between vaginal microbiota and female infertility: a systematic review and meta-analysis. Archives of Gynecology and Obstetrics. 2020;302:569-78.
Moragianni D, Dryllis G, Andromidas P, Kapeta-Korkouli R, Kouskouni E, Pessach I, et al. Genital tract infection and associated factors affect the reproductive outcome in fertile females and females undergoing in vitro fertilization. Biomedical Rep. 2019;10(4):231-7.
Leitich H, Kiss H. Asymptomatic bacterial vaginosis and intermediate flora as risk factors for adverse pregnancy outcome. Best Pract Res Clin Obst Gynaecol. 2007;21(3):375-90.
Martin DH. The microbiota of the vagina and its influence on women’s health and disease. The Am J Med Sci. 2012;343(1):2-9.
Shipitsyna E, Roos A, Datcu R, Hallén A, Fredlund H, Jensen JS, Engstrand L, Unemo M. Composition of the vaginal microbiota in women of reproductive age–sensitive and specific molecular diagnosis of bacterial vaginosis is possible. PloS one. 2013;8(4):60670.
Schwebke JR, Desmond R. Natural history of asymptomatic bacterial vaginosis in a high-risk group of women. Sexually transmitted diseases. 2007;34(11):876-7.
Moreno I, Codoñer FM, Vilella F, Valbuena D, Martinez-Blanch JF, Jimenez-Almazán J, Alonso R, Alamá P, Remohí J, Pellicer A, Ramon D. Evidence that the endometrial microbiota has an effect on implantation success or failure. Am J Obst Gynecol. 2016;215(6):684-703.
Mastromarino P, Hemalatha R, Barbonetti A, Cinque B, Cifone MG, Tammaro F, Francavilla F. Biological control of vaginosis to improve reproductive health. Ind J Med Res. 2014;140(1):91-7.
Naz RK, Butler A, Witt BR, Barad D, Menge AC. Levels of interferon-γ and tumor necrosis factor-α in sera and cervical mucus of fertile and infertile women: implication in infertility. Journal of reproductive immunology. 1995;29(2):105-17.
Pawanarkar J, Chopra K. Prevalence of lower reproductive tract infection in infertile women. Health Popul Perspect Issues. 2004;27(2):67-75.
Durugbo II, Nyengidiki TK, Bassey G, Wariso KT. Bacterial vaginosis among women with tubal factor infertility in Nigeria. Int J Gynecol Obst. 2015;131(2):133-6.
Hillier SL, Nugent RP, Eschenbach DA, Krohn MA, Gibbs RS, Martin DH, Cotch MF, Edelman R, Pastorek JG, Rao AV, McNellis D. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. New Engl J Med. 1995;333(26):1737-42.
Mania-Pramanik J, Kerkar SC, Salvi VS. Bacterial vaginosis: a cause of infertility. Int J STD & AIDS. 2009;20(11):778-81.
Ralph SG, Rutherford AJ, Wilson J. Influence of bacterial vaginosis on conception and miscarriage in the first trimester: cohort study. BMJ. 1999;319(7204):220-3.
Wilson JD, Ralph SG, Jackson F, Rutherford AJ. Infertility, preterm birth, and bacterial vaginosis. The Lancet. 1999;354(9177):511.
Wilson JD, Ralph SG, Rutherford AJ. Rates of bacterial vaginosis in women undergoing in vitro fertilisation for different types of infertility. BJOG. Int J of Obst Gynaecol. 2002;109(6):714-7.
Dehkordi FS, Tavakoli-Far B, Jafariaskari S, Momtaz H, Esmaeilzadeh S, Ranjbar R, et al. Uropathogenic E. coli in the high vaginal swab samples of fertile and infertile women: virulence factors, O-serogroups, and phenotyping and genotyping characterization of antibiotic resistance. New Mic New Infect. 2020;38:100824.
Okonofua FE, Ako-Nai KA, Dighitoghi MD. Lower genital tract infections in infertile Nigerian women compared with controls. Sexually Transm Inf. 1995;71(3):163-8.
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