The condition of vaginal biocenosis in pregnant women after application of assisted reproductive technologies
Authors:   Bogomolets National Medical University, Kyiv, Ukraine, Vygivska L.M. , Maidannyk I.V. ,   Bogomolets National Medical University, Kyiv, Ukraine, Oleshko V.F. ,   Bogomolets National Medical University, Kyiv, Ukraine,
Published: April 2022

The article presents the results of a prospective clinical examination of women with a history of burdened infertility, whose pregnancy occurred as the result of assisted reproductive technologies application. The objective: to study the peculiarities of vaginal biocenosis condition in the dynamics of pregnancy in pregnant women after ART application in order to improve the tactics of antenatal observation and prevention of obstetric and perinatal complications. Materials and methods. In order to achieve the aim comprehensive examination of 299 pregnant was conducted. Women were divided into two groups: the main group included 249 women whose pregnancy occurred as a result of ART application. The control group consisted of 50 pregnant women with spontaneous onset of pregnancy and its physiological course, which have been taken to the antenatal supervision in the period of 6-8 weeks of pregnancy. Pregnant women of the examined groups was carried out to determine the pH of the vaginal content, amine test, bacterial screening of the vaginal contents, examination for the presence of sexually transmitted infections and TORCH infections. Results. Bacterial vaginosis manifestations in 28.7% (27 cases) of I group women and in 19.5% (17 cases) of II group women and were significantly different from those of control group pregnant (p<0.05). Aerobic vaginitis associated with the active proliferation of conditionally pathogenic aerobic microflora which was detected in 39.4% of pregnant women. Bacteriological examination of I group pregnant women revealed that in the spectrum of isolated microflora microaerophils – Gardnerela vaginalis and Atopobium vaginae were most often in association with Mobiluncus and some representatives of aerobic microflora (S. faecalis, E. coli, Klebsiella spp). It should be noted that the state of microecology of the genital tract in the pregnant of the main groups was characterized by a significant increase in the composition of the aerobic microflora of seeding indicators of aerobic conditionally pathogenic microorganisms with pathogenic properties (hemolysis, plasma coagulation, lycitin activity). In particular, these women experience an increase in the incidence and concentration of staphylococci, streptococci and Escherichia with hemolytic properties. Conclusions. For women who have become pregnant as a result of ART application, it is advisable to use routinely test strips to determine vaginal pH as a screening method for selecting pregnant women for an in-depth cultural examination of the vaginal biotope. At pH > 4.4, in addition to microscopy of vaginal smears to determine the degree of activation of the leukocyte reaction, it is advisable to carry out an amine test, bacteriological examination with the obligatory quantification of the concentration of the detected agents, as well as sowing to determine the anaerobic microflora. Key words: pregnancy, infertility, assisted reproductive technologies, vaginal biocenosis.